WEST DEPTFORD JUNIOR WRESTLING

Subscribe to our Newsletter

West Deptford Wrestling Registration Form 2019-2020

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

(AGE IS DETERMINED BY THE CHILDS AGE ON DECEMBER 31ST 2018)
I/We the parent(s)/guardian(s) of the above named wrestler, who is a candidate for the position of the West Deptford Jr. Wrestling Team, do hereby give my/our approval to his/her participation in all activities of the West Deptford Jr Wrestling team during the 2019/2020 season. I/We assume all of the risks and hazards incidental to the conduct of the activities and transportation to/from the associated activities. I/We do herby release, absolve, indemnify, and hold harmless the West Deptford Jr Wrestling team, as well as organizers, sponsors, volunteers, coaches, supervisors, and league officials. In case of injury to my/our child/children, I/We hereby waive all claims against the organizers and any of the supervisors, coaches, and assistants appointed by them. I/We likewise release from responsibility any person(s) transporting my child to and from the activities of the West Deptford Jr. Wrestling Team. To date, I /We have no knowledge of any medical problems or conditions that might endanger or preclude the forenamed child form participating in this activity. Any other medical conditions, which I/We agree are not serious enough to preclude my/our child's participation in the activities of West Deptford Jr. Wrestling Team, as noted above. If the participant us currently under doctor's care. I/We will consult the participating child's physician prior to his/her participation. I/We give our child/children to have photos taken and published on any website and newsletter.

I/we agree with the above *

Tot (4-6 year olds)

Bantam (7-8 year olds)

Midget (9-10 year olds)

Juniors:

Additonal Wrestler Name and Birthdate:

Signature:

Date:

Signature:

Date:

* indicates required fields

IMPORTANT: Online Payment with credit cards is not active for this form

OUR SERVICES

LOCAL SPORTS

ELITE

West Deptford Wrestling Registration Form 2019-2020