BREWSTER WRESTLING CLUB

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BREWSTER WRESTLING CLUB REGISTRATION 2018-2019

WRESTLER INFORMATION

* First Name:

* Last Name:

* Birthdate:

Grade:

* Shirt Size:

* Request Headgear:

Yes

First Name Wrestler #2:

Last Name Wrestler #2:

Birthdate Wrestler #2:

Grade Wrestler # 2:

Shirt Size Wrestler #2:

Request Headgear Wrestler #2:

Yes

First Name Wrestler #3:

Last Name Wrestler #3:

Birthdate Wrestler #3:

Grade Wrestler #3:

Shirt Size Wrestler #3:

Request Headgear Wrestler #3:

Yes

* Street:

* City:

* State:

* Zip Code:

* Home Phone:

* Email:

PARENT/GUARDIAN

* Firstname:

* Lastname:

* EMail:

* Home Phone:

* Work Phone:

* Cell Phone:

WAIVER INFORMATION

MINOR RELEASE
In consideration of my acceptance of this application I give my child permission to enter The Brewster Wrestling Club at his/her own risk. I hereby release any and all claims I may have against the officials, referees, sponsors, volunteers, coaches, Thomas Looby, The Brewster Wrestling Club or Brewster Central School District and its employees as well as USA Wrestling from any liability for any injuries or losses suffered directly or indirectly as a result of traveling to and from, practicing or competing in The Brewster Wrestling Club. AND I, THE MINOR'S PARENT AND/OR LEGAL GUARDIAN, UNDERSTAND THE NATURE OF THE ACTIVITY AND THE MINOR'S EXPERIENCE AND CAPABILITIES AND BELIEVE THE MINOR TO BE QUALIFIED, IN GOOD HEALTH, AND IN PROPER PHYSICAL CONDITION TO PARTICIPATE IN SUCH ACTIVITY. I HEREBY RELEASE, DISCHARGE, COVENANT NOT TO SUE, AND AGREE TO INDEMNIFY AND SAVE AND HOLD HARMLESS EACH OF THE RELEASEE'S FROM ALL LIABILITY, CLAIMS, DEMANDS, LOSSES, OR DAMAGES ON THE MINOR'S ACCOUNT CAUSED, OR ALLEGED TO BE CAUSED, IN WHOLE OR IN PART BY THE NEGLIGENCE OF THE "RELEASEES" OR OTHERWISE, INCLUDING NEGLIGENT RESCUE OPERATIONS AND FURTHER AGREE THAT IF, DESPITE THIS RELEASE, I, THE MINOR, OR ANYONE ON THE MINOR'S BEHALF MAKES A CLAIMS AGAINST ANY OF THE RELEASEES NAMED ABOVE, I WILL INDEMNIFY, SAVE, AND HOLD HARMLESS EACH OF THE RELEASEES FROM ANY LITIGATION EXPENSES, ATTORNEY FEES, LOSS LIABILITY, DAMAGE, OR ANY COST THAT MAY OCCUR AS A RESULT OF ANY SUCH CLAIM.

I/we agree with the above *

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BREWSTER WRESTLING CLUB REGISTRATION 2018-2019