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Seattle Wrestling Club Registration
Please fill out this form to the best of your knowledge for each wrestler registering. Keep in mind that this could take some time and once you have started, you're answers will not be saved.
Wrestler's Name (Last, First) *
Your answer
Date of Birth *
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Weight (lbs) *
Your answer
Grade in School *
Parent/Guardian Name *
Your answer
Relationship to Wrestler *
Your answer
Wrestler's USA Wrestling Card No. *
Your answer
Address *
Your answer
Main Phone Number *
Your answer
Secondary Phone Number
Your answer
Email *
Your answer
PARENT'S INSTRUCTIONS ON MEDICAL TREATMENT
Please indicate another person to call if an accident occurs and we are unable to reach you:
Name *
Your answer
Phone No. *
Your answer
Insurance Company Policy No. *
Your answer
Family Doctor *
Your answer
Phone No. *
Your answer
Is your child presently on medication? *
If yes, please list medication (s):
Your answer
Drug Sensitivities
Your answer
Other Allergies
Your answer
Date of your child's last complete physical examination by a medical doctor *
MM
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DD
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YYYY
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