Downriver Wrestling Camp

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Monday June 17- Thursday June 20, 2024

Email *

Wrestler's Last Name *

Wrestler's First Name *

Wrestler's Birthdate *

YYYY

Wrestler's Grade entering fall of 2024 *

Shirt Size Guaranteed if registered by June 5

Youth L

Adult S

Adult M

Adult L

Adult XL

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Wrestler's Address *

Parent 1 Name *

Parent 1 email *

Parent 1 cell *

Parent 2 Name

Parent 2 email

Parent 2 cell

RELEASE and WAIVER of LIABILITY and INDEMNITY AGREEMENT *

I hereby give permission for my child to participate in the summer camp provided by Grosse Ile Wrestling Club at Grosse Ile High School. I agree that my child is participating at his/her own risk, releasing Grosse Ile Wrestling Club, Grosse Ile High School, Downriver Wrestling camp instructors, both now and in the future, from any accident, injury, illness or death which may occur as part of the camp. In the event that my child is injured and required emergency medical or dental treatment by a licensed practitioner, I hereby give my consent for the emergency transfer of my child to a hospital, and permission to the physician to secure proper treatment for and to order injection, anesthesia, x-rays, routine tests, treatment, transporting of child, surgery and to release reports necessary for insurance purposes for my son/daughter and that I will assume all financial responsibilities. It is understood that every effort will be made to contact me. I further understand that if my child is responsible for any damage done to any property, we as parents/guardians will be held responsible for my child’s actions.

Required

Allergies/Medical Concerns *

Camp cost is $50 *

cash or check due on June 17 first day of camp

By entering your initials below, you agree that you are the parent or legal guardian of the above named camper, and are over the age of 18. In case of medical emergency or general medical care, I give consent for medical treatment for the above named camper by authorized personnel. I understand that the above named camper will only be released to the names listed above, an update may be done at registration. I certify that my child has my permission to attend camp and participate in all activities. Electronic signature, please initial.* *

A copy of your responses will be emailed to the address you provided.

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