***Pre-Registration is now OPEN, and will remain open tiil Tuesday, April 20th.***
First Name
Address
State
Zip Code
City
Age
Phone
Email
***PLEASE READ***

- To complete this form, please make sure to click "Submit" at the bottom of the page. 

  - Within 24-48 hours of submitting your information, you will receive a Paypal Invoice request (via email). You DO NOT need to create a Paypal account in order to pay for your regsitration.

  - If you do not have an email account, please contact us.  We may be able to secure an alternitive payment option.

  - If you submit your registration, but do not receive a Paypal Invoice request, please contact us at 
(dustin@ohiograpplingchallenge.com) or (614-288-0398).

  - PLEASE NOTE, submitting this form DOES NOT
mean that you have been registered.  Payment must be recived by Wednesday, April 21st at 5:00pm in order for you to be considered REGISTERED.  
Area Code
Last Name
BJJ Rank
No-Gi Skill Level
Team
Pre-Registration for April 24th, 2010
Male
Female