Auburn Youth Wrestling Club

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Auburn Wrestling 2018-2019 Registrations

PLAYER INFORMATION

* First Name:

* Last Name:

* Street:

* City:

* State:

* Zip Code:

* Home Phone:

* Birthdate:

* Email:

* Gender:

* Grade:

PARENT/GUARDIAN #1

* Firstname:

* Lastname:

EMail:

* Home Phone:

Work Phone:

* Cell Phone:

PARENT/GUARDIAN #2

* Firstname:

* Lastname:

* Email:

* Home Phone:

Work Phone:

Cell Phone:

MEDICAL/EMERGENCY CONTACT INFORMATION

* Emergency Contact:

* Phone:

* Relationship to Player:

* Insurance Carrier:

* Policy #:

WAIVER INFORMATION

The undersigned participant and his/her parent/legal guardian agree to hold Auburn Youth Wrestling Club, its coaches, trustees, and volunteers harmless from any claims, damages, losses and/or expenses arising out of participation in wrestling activities and to assume all liability for any and all personal injury, body injury, illness or property damage that occurs as a result of participation in such wrestling activities. Signature of this agreement also warrants that participation in wrestling is voluntary and that the participant and undersigned have read and understand the inherent risks involved in the wrestling club activities. The participant understands that these risks exist despite the wrestling club’s safety precautions and procedures and the participant agrees to obey all rules
and policies mandated by the wrestling club coaches and trustees.

The undersigned participant and his/her parent/legal guardian warrant that the participant is physically fit and able to participate in all wrestling activities and that there is and will be adequate health insurance coverage in force for the term of the participant’s attendance. The undersigned further verifies that the health insurance covers any and all accidents, injuries or illnesses that may result from participation in the wrestling club activities. In addition, the participant and his/her parent/legal guardian agree to give the Auburn Youth Wrestling Club and its representatives permission to provide emergency medical response and/or treatment as needed for any injury or illness that may occur while the participant is involved in wrestling activities and agree to release the Auburn Youth Wrestling Club and its representatives from all liability arising out of such treatment.

I/we agree with the above *

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Auburn Wrestling 2018-2019 Registrations