Mighty Men Wrestling Club Registration

Mighty Men Wrestling Club Registration & Waiver Form
Full Name*
Date of Birth*

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Date
Age*
School/Grade*
Address

Street Address

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Parent/Guardian Name *
Relationship
Phone Number*
Email*
example@example.com
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Emergency Contact
Name*
Relationship*
Phone Number*
AllergiesConditions*
Medications*
Waiver & Release of Liability I, the parent/guardian of the athlete named above, understand that wrestling is a physically demanding sport that may involve risk of injury. By signing below, I agree to the following:

I hereby release Mighty Men Wrestling Club, its coaches, volunteers, and staff from any and all liability for injuries, damages, or losses sustained during practices, competitions, or

I understand that it is my responsibility to provide medical insurance for my child.
I certify that my child is physically fit to participate in wrestling and has no conditions that would prevent safe participation.

I grant permission for emergency medical care if necessary.
Parent/Guardian Signature*

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Date*

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USA Wrestling Membership All wrestlers must have a valid USA Wrestling Athlete Membership for insurance and competition purposes.
You can get the USA Wrestling Membership at www.usawmembership.com

Please bring proof of membership when submitting this registration form
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Monthly Fee
$40.00 Quantity

Yearly Fee
$400.00 Quantity

Total

$0.00
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