Wrestlers First Name Wrestlers Last Name Email Address Address City State Zip Phone Choose a Class Choose a Class Camp 1 - June 23-28 Camp 2 - July 10-12 School Grade Shirt Size Age Birthday Years Wrestling Parent/Gardian Relation Home Phone Cell Phone Parent Email Emergency Contact Relationship Home Phone Cell Phone Please add me to your Mail List to be notified of upcoming events. Please add me to your Mail List to be notified of upcoming events. Please add me to your Mail List to be notified of upcoming events. Waiver: I hereby agree to hold harmless Valdez Wrestling Club, LLC and their respective staff and/or their affiliates in the event of injury or Covid-19 illness at the present time and/or in the future as a result of participation in any and/or all of activities. I certify that my child and/or I is/are in good physical health and has/have had a physical examination in the past year. I understand I will not bring my child to classes if s/he is ill or presents with any symptoms of Covid-19. I understand that classes may be physically strenuous and my child and/or I voluntarily participate in them with full knowledge that there is risk of personal injury, property loss, or death. I authorize and their respective staff and/or their affiliates to act on my behalf in the event of a medical emergency. Therefore, in case of injury or illness, necessary emergency treatment is authorized. I further agree to be held fully responsible for all medical cost incurred both now and in the future, as a result of any injuries sustained while participating at any and/or all of activities. I agree that either I, my heirs, assigns or legal representatives will not sue or make any other claims of any kind whatsoever against or its members for any personal injury, property damage/loss, or wrongful death, whether caused by negligence or otherwise. I further consent to my child and/or I being photographed and/or videotaped for promotional use. Waiver: I hereby agree to hold harmless Valdez Wrestling Club, LLC and their respective staff and/or their affiliates in the event of injury or Covid-19 illness at the present time and/or in the future as a result of participation in any and/or all of activities. I certify that my child and/or I is/are in good physical health and has/have had a physical examination in the past year. I understand I will not bring my child to classes if s/he is ill or presents with any symptoms of Covid-19. I understand that classes may be physically strenuous and my child and/or I voluntarily participate in them with full knowledge that there is risk of personal injury, property loss, or death. I authorize and their respective staff and/or their affiliates to act on my behalf in the event of a medical emergency. Therefore, in case of injury or illness, necessary emergency treatment is authorized. I further agree to be held fully responsible for all medical cost incurred both now and in the future, as a result of any injuries sustained while participating at any and/or all of activities. I agree that either I, my heirs, assigns or legal representatives will not sue or make any other claims of any kind whatsoever against or its members for any personal injury, property damage/loss, or wrongful death, whether caused by negligence or otherwise. I further consent to my child and/or I being photographed and/or videotaped for promotional use. I agree to the Waiver Date I have read the above waiver and release and understand that I have signed it voluntarily. Type Full Name Submit
