Shane Roller's 2010 All-Star Camp Application


Thanks for your interest in our wrestling camps!

* Indicates Required Fields

*I wish to enroll in:
Session Deposit Cost                Date               
Technique - 6 Day $100 Resident $275
June 27 - July 2, 2010
Intensive - 6 Day $100
Resident $400
June 27- July 2, 2010
Coach/Parent $150
Coach/Parent $150



*Camper Name *Address
*City *State
*Zip Code *Email
*Parent/Guardian Name
(first) (last)
*Home Telephone *Work
  (format)   111   111-1111   111   111-1111
*School Attending
*Grade Next Year      *Age     *Weight
 
Health Information
*Health Insurance Company
*Policy Number(s)


*T-shirt Size:XS  XL  XXL   (Adult Sizes - 100% Cotton)



*Please charge a deposit of : $

You may pay more than the minimum deposit shown or pay the the full amount of $.
A balance of $ is Due upon arrival to Camp.
Please note that your deposit is NON-REFUNDABLE.

Payment Via Secure PayPal


PERMISSION FOR MEDICAL TREATMENT, RELEASE OF MEDICAL INFORMATION AND PAYMENT OF MEDICAL EXPENSE: I REQUEST AND GIVE PERMISSION to physicians and medical staff to treat the above-named participant appropriately, including hospitalization, prescribing medication, and performing emergency medical procedures. I AUTHORIZE release of any medical information to the medical centers which may be pertinent to any diagnosis or treatment of the above-named participant. I UNDERSTAND that any charges resulting from this medical treatment will be billed to me at my address or to my medical insurance carrier.

Waiver: My son/daughter has been examined by a physician in the last year and is in good health. I hereby authorize the Shane Roller All Star Camp Staff to act for me, according to its best judgement in any medical emergency, and I hereby waive and release said camp from any liability for injuries or illness incurred by my son/daughter while attending camp.


*I agree to the terms listed above


    


Upcoming Tournaments

We have several upcoming tournaments for the 2009-2010 season. Please click the "View All" button below for a listing of tournaments and registration information.

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Recent Updates

New Locations

Two new locations are open for a World of Wrestling Tournament! If you or your team are interested in helping in your area, contact your local Convention & Visitors Bureau or Sports Commission and have them give Jack Roller a call at 918-366-4411.

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Our Sponsors

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Testimonials

Mr. Roller, My son and I are really looking forward to attending Tulsa Nationals, “The Super bowl of Wrestling.” This is our third trip up there. First time placed 6th, second time went 2 and out, and the upcoming attempt is obviously to be determined. Our first year I would have bet my house that there was no kid in the country that could beat him. Glad I didn’t bet; he took 6th. Two years later my son said that’s what he wanted for Christmas was to win Tulsa. The level of competition is really amazing and the way it is run with the number system is very fan and wrestler friendly. I just want to thank you for putting on the best tournaments in the world; bar none. You guys up there don’t know how good you got it to have a tournament like that in your back yard. Down here in Florida we can only dream to have a tournament of that caliber. But for us it is a measuring stick to see where we are really at. Thanks for all your hard work and dedication to the greatest sport in the world. Also big thanks to Mike Krause and Flo Wrestling. I used to be just an old concrete man now I’m a Flo Wrestling junkie. WHAT I SAY TO ALL COACHES AND PARENTS WHO THINK THEIR KIDS ARE TOUGH, PUT THEM ON A PLANE, FLY THEM OUT TO TULSA AND YOU CAN SEE HOW TOUGH THEY REALLY ARE. Thank you, Greg Taylor

dylan taylor


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