BUCKEYE LOCAL WRESTLINGS

I/we, the parents or guardians of ____________________________ acknowledge and fully understand that he/she will be participating in activities that involve risk of serious injury, permanent disability and/or death resulting from their own actions, inactions, or negligence, and/or from the actions, inactions or negligence of others, the rules of play, the conditions of the premises or the conditions of any equipment used. In consideration of being allowed to participate, I/we release, waive, discharge and covenant not to sue This Wrestling organization (Buckeye Local Wrestling Pin Club), its officers, agents, coaches, employees, volunteers or sponsors and any owners and lessees of premises (specifically Buckeye Local H.S. and the Buckeye Local School system) used to conduct the program event(s) from any and all liability including but not limited to any claims, demands, losses or damages on account of injury, death or damage to property, caused or alleged to be caused in whole or part by the negligence of those associated with program. Furthermore, I certify that my child has full medical and hospital coverage through a family protection policy and my child has had recent physical updates that have cleared him/her for participation consistent with activities in our program (including any conditions listed above). I (the undersigned) assume any liability for expenses or physical damages to my child that might occur from activities related to the Wrestling program.

LACE EM UP LEG WRESTLING technique CAMP

For wrestlers entering 7 t h -12 t h grades
Brought to you by:

Ohio State Wrestler

David Rella
Name: ____________________________

Grade: ____________________________ Date of Birth: ______________________ Weight Class:_______________________

School: ____________________________ Address: ___________________________ City/State/Zip Code:__________________

T-shirt Size: S

L XL

XXL

Emergency Contact: _______________________

Phone: __________________________________

__________________________________ Parent/Guardian And Date

Cell/Work Phone: __________________

For any Questions or Concerns please contact: buckeyelocalpinclub@gmail.com Checks Made Payable To:
Buckeye Local Wrestling Club

Mail To:
Patrick Mason PO Box 351 Smithfield, OH 43948

Lace Em UP Schedule
Tue. July 9th Session 1: 10:00 am 12:00 pm Lunch: 12:00 pm 1:00 pm Session 2: 1:00 pm 3:00 pm Live Wrestling: 3:00 pm 3:45 pm

July

9th

&

10th,

2013

Wed. July 10th Session 1: 10:00 am 12:00 pm Lunch: 12:00 pm 1:00 pm Session 2: 1:00 pm 3:00 pm Live Wrestling: 3:00 pm 3:45 pm

David Rella

Our Mission
PLACE PHOTO HERE, OTHERWISE DELETE BOX

-3x Ohio High School State Finalist, 2x Champion, State Tourn. MVP -- High School Senior National Champion -Penn State Varsity 2 yrs - Ohio State Varsity 2 yrs - 4x Big 10 Place winner

.
IF A WRESTLER HAS TWO LEGS AND I CAN RIDE EM . I KNOW I CAN WIN!

AN AFFORDABLE CAMP: $75

Eligibility: Wrestlers entering 7th through 12th grade. What to Bring: Please bring a couple of sets of workout clothes for each day and tape if needed. You are welcome to bring drinks if you would like. DO NOT bring any money or personal items of great value! Each wrestler will have a spot to place their items, but there are no lockers available. *Lunch will be provided. Location: Buckeye Local High School 10692 State Highway 150 Rayland, Ohio 43943

- 4x NCAA Qualifier - Fila Jr. Freestyle World Team Member (Beijing) - USA Fila Jr. Freestyle National Champion (Las Vegas)

-- PAN American Freestyle List you Champion, Greco Romanproduct Runner-Up (Venezuela)-European Freestyle National List you Champion (Romania)

product

Please Register by: June 25, 2013 Limited Spots Available!!!

This camp is limited to the first 40 paid applicants

List you product

List you product

List you product