James L. Day Wrestling Club Registration
So you want to learn wrestling? Excellent! Get a parent or guardian to help you with this registration form.
Email address *
Wrestler's Last Name *
Wrestler's First Name *
Gender *
Can you attend 2 to 6 practices a month after school in the Day Middle School MPR? Usually 3-4:30pm *
Would you be interested in being a club officer or representative? *
Mom's/Guardian's Name
Mom's/Guardian's Mobile Phone #
Dad's/Guardian's Name
Dad's/Guardian's Mobile Phone #
Parent/Guardian Email
City *
Grade *
Advisement Teacher *
Weight (approximate)
Emergency Contact *
Emergency Contact's Phone Number *
Any physical limitations or medical conditions *
WAIVER AND RELEASE AGREEMENT : By clicking the box below I give permission for my son/daughter to wrestle at James L. Day Middle School. I understand that Day Middle School and Mr. Helm are not liable for any injuries that may occur to my child during wrestling. I am signing a separate “Hold Harmless” agreement and returning that to Mr. Helm. *
Name of Parent/ Guardian *
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