Wilmington Youth Wrestling

Subscribe to our Newsletter

2019-2020 Wilmington Wrestling Registration Form

WRESTLER'S INFORMATION

* First Name:

* Last Name:

* Street:

* City:

State:

* Are you a returning Wrestler:

* Wrestler's Home Phone:

* Birthdate:

Gender:

* Grade as of September 2019:

Age:

* Team Tshirt Size (for purchase):

* Sibling Signup:

Name:

Grade as of September 2019:

Age:

Birthdate:

Team Tshirt Size:

PARENT/GUARDIAN #1

* First name:

* Last name:

* Email:

* Home Phone:

Work Phone:

* Cell Phone:

PARENT/GUARDIAN #2

First name:

Last name:

Email:

Home Phone:

Work Phone:

Cell Phone:

* Please list the email(s) you prefer for all wrestling correspondance below:

* Health Issues to be aware of: Please list any asthma, food/environmental allergies, or other medical issues that you'd like us to be made aware of. If none, write none.:

* Best phone number to be reached at during practice hours:

MEDICAL/EMERGENCY CONTACT INFORMATION OTHER THAN PARENT/GUARDIAN INFORMATION

* Emergency Contact:

* Phone:

* Relationship to Player:

* Insurance Carrier:

* Policy #:

10% EARLY REGISTRATION DISCOUNT!!! Payments received by November 1st 2019 will receive and a 10% discount off the total. [No exceptions]

* How many wrestlers being signed up for this registration?:

[1]

[2]

[3]

* Registration Fee is $185/wrestler (w/ certain discounts):

I understand Registration Fee must be paid in full by November 30th to secure your child's place, unless specific arrangements have otherwise been made with Coach Fox. *

Singlets are issued on a loaner basis & are the property of Wilmington Wrestling. Unreturned singlets will incur an $80 per replacement fee. (If in possession of any singlets from 2018-2019, please make arrangements w/ Coach Fox before registration). *

* Payment Methods (See Below) - MUST BE RECEIVED BY 11/30:

*If attending, there will be a Year-end Banquet Fee of $15/family to be collected prior to the event.

WAIVER INFORMATION

CONSENT AND RELEASE FORM
I, the undersigned parent/guardian, wish to register the child indicated above in the Wilmington Youth Wrestling Program. I give my permission for the coaches to administer first aid and to authorize emergency treatment by a doctor, if necessary. I am aware of the risk of injury inherent in any sport and hereby release WILMINGTON YOUTH WRESTLING and all of its officers, members, directors, employees, agents, board members, volunteers, coaches, assistants, administrators, Wilmington High School (or any other participating venues for scrimmages and/or tournaments) or other associates of Wilmington Youth Wrestling, assisting, participating or providing services in the Program from any and all claims, rights of action and causes of action that may have arisen in the past, or may arise in the future, directly or indirectly, from personal injuries to the child or property damage resulting from the child's participation in the Program.
The registrant child is medically fit to play sports. I also certify that the date of birth and other information given above is true to the best of my knowledge. The undersigned parent/guardian represents that she/he is not aware of any physical illness or injury that would prevent the registrant child from participating in the program, and further, he/she represents that the registrant child has received a complete and satisfactory physical examination by a medical doctor in the past 12 months.

PHOTOGRAPH AUTHORIZATION. I, do hereby acknowledge that Wilmington Youth Wrestling and its affiliated programs, will photograph participants and publish such photographs for promotional use, display or for posting on its or its websites, newspaper, and brochures. I/We, the undersigned, hereby consent to the photographing of my/our child or ward any publishing of such photographs for the purposes stated herein or for purposes related to the program in which my/our child is participating.

I/WE AGREE WITH ALL OF THE ABOVE. *

* indicates required fields

OUR SERVICES

LOCAL SPORTS

ELITE

2019-2020 Wilmington Wrestling Registration Form