2019 Back 2 School BRAWL Wrestling Tournament Registration
November 23, 2019
9:00 am
Charles County Fairgrounds
Information, Consent and Release
Wrestler First & Last Name: *
Your answer
Wrestler USA Wrestling ID Number: *
Your answer
Nickname (if preferred)
Your answer
Date of Birth *
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Age *
How many years wrestling? *
Your answer
Experience? *
Weight (weigh-in required: 11/22/19, 6-7pm, 11/23/19, 7-8am) *
Your answer
Wrestling Club Name *
Your answer
Address
Your answer
Parent/Legal Guardian's Contact Information
1. First and Last Name *
Your answer
Cell Phone Number *
Your answer
Email Address *
Your answer
2. First and Last Name
Your answer
Cell Phone Number
Your answer
Email Address
Your answer
I/We hereby grant permission to the above listed minor to participate with the Back 2 School BRAWL Wrestling Tournament.
Parent/Legal Guardian's Signature (type name) *
Your answer
Date *
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General Publicity Release
The Undersigned acknowledges and agrees that this publicity release is a general release and applies without exception to all activities that the participant competes in, attends or is otherwise involved with in any manner, directly or indirectly at any time.
Wrestling Medical Information
This is private medical information and will only be shared with emergency responders. This form gives our coaches and administrators instructions with how to proceed if your son/daughter becomes injured or ill and needs emergency treatment during your absence.
Wrestling First, Middle & Last Name (Jr/III) *
Your answer
Date of Birth *
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DD
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List Allergies *
Your answer
List Medical Conditions *
Your answer
Medical Treatment
Please read the alternative statements, check only one preferred option
Pick one *
Parent/Legal Guardian Signature *
Your answer
Date *
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Waiver and Release
We understand that the sport of wrestling, in which our child will participate, is potentially dangerous and that physical injuries may occur requiring emergency medical care and treatment. We assume the risks of injury which may occur in this athletic activity. We agree to hold harmless the BACK 2 SCHOOL BRAWL WRESTLING TOURNAMENT, the JC BRAWLERS WRESTLING CLUB and its affiliated wrestling clubs, their members, all coaches, and any and all other agents and agree to indemnify each of them from any claims, costs, suits, action judgments and expenses arising from our child’s participation in youth wrestling and any injuries received and expenses related thereto.
Parent/Legal Guardian Signature *
Your answer
Date *
MM
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Submit
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