2018/2019 Registration

WRESTLER INFORMATION

PARENT/GUARDIAN #1

PARENT/GUARDIAN #2

MEDICAL/EMERGENCY CONTACT INFORMATION

WAIVER INFORMATION
I, the parent or legal guardian, do hereby grant permission for the above listed child to participate in the
Parkway Youth Wrestling (PYW) program, in any and all team activities including out of state travel. I
understand that the PYW organization, its board, coaches and the Roxbury Latin School do not assume
liability for expenses, medical, or otherwise incurred as a result of participating in the PYW program. I agree to
assume all risks and hazards incidental to the participation on the wrestling team, including transportation to
and from the activities. I do hereby waive, release, absolve, indemnify and agree to hold harmless PYW, the
officers, sponsors, volunteers, participants and persons transporting my child to and from any and all team
activities, for any claim arising out of an injury to my child, whether a result of negligence or for any other cause.
I understand and accept that there is a chance an injury may arise from my child’s participation in the sport of
wrestling. I hereby grant permission to the PYW organization to administer first aid, secure proper treatment and/or hospitalize my child in case of emergency, provided they are unable to communicate with me in accordance with their best judgment.

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Payments Accepted By

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