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* 1. Name of Wrestler

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* 2. Wrestler Birthdate - month/day/year

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* 3. 2019 OKUSA or jr high State Placement

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* 4. School grade for the 2019-2020 school year:

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* 5. what weight would you like your wrestler to compete at on the National Team?
72, 76, 80, 84, 88, 92, 96, 100, 105, 110, 115, 120, 130, 140, 160, 210 PLUS 1lb weight allowance

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* 6. Parent's Name

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* 7. Parent's Phone number:

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* 8. Parent's email:

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* 9. I would like my wrestler to participate on the 2019 MIDDLE SCHOOL OKUSA NATIONAL TEAM

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* 10. YOU MUST CONTACT SHAWN BATEMAN (580-641-0596) ASAP IF ANY OF THE ABOVE INFORMATION CHANGES AT ANY TIME OR IF YOU NO LONGER WANT TO / CAN PARTICIPATE IN THESE DUALS

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