Name of organization (School District, Mat Club, etc.):


Ages/grades eligible:


Fee to join/benefits (e.g. T-shirt, entry fees for tournaments):


Sign-up location, date, and time:


Contact person for sign-ups (Name, Phone, E-mail):


Date to begin practices; weekly practice schedule:


Location for Practices:


Program Director and/or Head Coach (Name, Phone, E-Mail):


Opportunities for parent volunteers (help needed):


Additional comments (Program's traditions, Coaching philosophy, Coach's qualifications, required equipment, etc.):




Please list any important Internet links to your school district's wrestling teams or Mat Club:


Optional (but strongly recommended): Please submit artwork of team's logo (e.g. a decal, photos of school, wrestling room, coaches, team, etc.)

Membership Fees: Please send this completed form and a check for $50 (made payable to SCPYWO) Treasurer Tom Kashatus, 153G E. High Street, Elizabethtown, PA 17022.

To participate in the electronic bulk entry of your wrestlers into SCPYWO sanctioned events, please print, complete, and sign a copy of the Member Program Agreement for Web Site Registrations; send the form to Mr. Kashtus at the above address along with this questionnaire and the membership fee.

Please address questions to:

John Bartges
Phone: 717-569-4484
Fax: 717-581-0177
E-Mail: bartges@redrose.net