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2019 Summer Clinic Registration Form
Please complete all of the fields below.
Email address *
Contact Information
Parent Name *
Your answer
Address *
Your answer
Phone Number *
Your answer
Participant Information
Name *
Your answer
Date of Birth *
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YYYY
USA Wrestling Card Number *
Your answer
Clinic *
Parent/Guardian Medical Waiver and Release Form
You agree and are aware that the participant named on this form will be engaging in physical exercise involving various sports, coordination events and general fitness training which could cause injury, illness or various skin infections.

You understand that the participant is voluntarily participating in these activities and is assuming all risks of injury, illness or skin infection that may result from engaging in any practice, exercise or sport related event including tripping, slipping, falling, colliding with another individual or object on or off the club premises.

You hereby agree to waive any claims or rights that you might otherwise have to sue the club, our employees, owners, officers, or agents for any injury, illness or skin infection that may occur. You understand that we will make no evaluation or recommendation as to whether or not the child is capable or deemed physically fit to engage in any activity. If the child has any physical or mental condition that may impair his or her ability to engage in any of the club activities, practices or exercises, it is your responsibility to obtain a physician’s release statement. It is recommended you consult a physician prior to your child participating in any practice, physical exercise or club activity.

I HAVE CAREFULLY READ THIS AGREEMENT, WAIVER, AND RELEASE AND FULLY UNDERSTAND ITS CONTENTS. I AM AWARE THAT THIS IS A RELEASE OF LIABILITY AND A CONTRACT BETWEEN MYSELF, THE ELWOOD YOUTH WRESTLING CLUB AND THE ELWOOD SCHOOL DISTRICT. I SIGN IT BY SELECTING THE CHECK BOX NEXT TO "I AGREE" BELOW.

Waiver Agreement *
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