Wrestling Registration Form
 

Last Name:  

First Name: 

Are you a NEW official to this NCOA Sports’ Group? Yes   No

Email Address:

Street Address: 

City: 

State:

Zip:

Phone (Area Code + Number):     

Date of Birth (xx/xx/0000)

Have you ever been convicted of a felony or crime
for which you are required to register?    Yes  No

The following questions are requirements of Twin Rivers Adult School Program (Please make one selection for each question 1 through 4)

1. Gender: Male  Female

2. Ethnicity (Select One):  Hispanic or Latino    Not Hispanic or Latino

3. Race (Select One): White Asian Black-Africian American Filipino 
 Native Hawaiian or other Pacific Islander American Indian Alaska Native
 Other

4. Student Type (Select One): Regular Adult Dislocated Worker Displaced Homemaker
 Economically Disadvantaged
 

Dues for the “First Sport” that you register for during each Scholastic year (each August to May) are $50.00 if received on or before the Early Registration deadline date for that Sport.  Dues received after the Early Registration deadline date for each Sport are $60.00. 

Dues, when registering for a “2nd, 3rd, etc,” Sport each Scholastic year, are $30.00 for that Sport if received on or before the Early Registration deadline date.  Dues, when registering for a 2nd, 3rd, etc, Sport each Scholastic year, are $40.00 for each Sport if received after the Early Registration deadline date.

Dues’ checks should be made payable to “NCOA” and mailed c/o Tom Murphy at 491 Wyndgate Road, Sacramento, CA 95864.  You should write your name and the Sport you are registering for in the Memo Field on your check….You will be able to pick up your instructional materials at the first meeting(s)…