Twister Wrestling Academy 2015
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First Name *
Last Name *
Date of birth *
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Weight *
T-Shirt Size *
School Name *
Email *
USA Wrestling Card # *
Phone number *
Address (Street, City, ST, Zip) *
Parent/Guardian Name *
Parent/Guardian Phone Number *
Upon acceptance of this application, I hereby waive and release any and all rights and claims against Columbus Public Schools and/or Columbus High School and all its employees and agents on account of any injuries or illness sustained by my child while attending camp/tournament.  I authorize the director of the camp of his/her designee to select hospital facilities and/or physician of his choice and authorize treatment on an emergency basis in the event such treatment becomes necessary as a result of participation in the Twister Wrestling Academy. *
I agree to the above by my digital Signature
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