Publish Agreement

							                Send this form filled out to the Website Maintenance Director, Dave
                Gilbertson at:

                Dave Gilbertson –   Website Maintenance Director
                Washington State Wrestling Association
                3614 103rd Pl. SE
                Everett, WA. 98208
                E-Mail: davegilbertson74@hotmail.com

      Agreement to Publish Club & Club Point Of Contact Information on the
               Washington State Wrestling Association Web Site:
                    http://www.WashingtonStateWrestling.com

By filling out specific information below, I agree to authorize WSWA to publish only the
information I have filled out on the State Wrestling Web Site.

Printed Name:

Club Affiliation:

Signature:

Club Name:

Club Point Of Contact Name:

Phone Number: (        )                      Fax Number:    (     )

Address:




E-Mail Address:

Club Web Site:

Surrounding Counties (close to area of practices):




Surrounding Cities (close to area of practices):