ETC HAMMER CAMP REGISTRATION

Name:_________________________________________DOB________________ Parent/Guardian:_____________________________________________________ Address:_______________________________________ Weight_______________ City:____________________________ Phone: _____________________________ Email:__________________________ Cell #: _____________________________ Emergency Contact (if not parent): _________________________ Ph# __________ Any Medical Info: ____________________________________________________ Parent/Guardian Employer: _____________________________________________ Consent & Authorization I, the undersigned, fully understand that my child will be engaging in activities that involve risk of serious injury, disability, or even death which might result from action, inaction, or negligence on their or others parts. I hereby accept the responsibility for the damages following such injury, disability, or death and release and discharge Elite Training Center Wrestling Club, members, board, employees, coaches, and leasers of premises used to conduct the event from any and all liability to each of the undersigned, heirs, or next of kin for any and all against any claim by or on behalf of the applicant as a result of participation in any club activities. I hereby give my consent to have an athletic trainer, each doctor or associated personnel to provide the participant with medical assistance and/or treatment and agree to be financially responsible for the cost of such assistance and/or treatment. I have read the above waiver/release and understand that (I)/we have given up substantial rights by signing this release and sign below voluntarily. Parent/Guardian Signature Registration : Cash ___________ Check__________ Date

USA Wrestling Card #_______________________