Registration Form

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Camp or Service(Required)

Wrestler Info

Wrestler Name(Required)

First Last

Phone(Required)

Email(Required)

Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

USA Wrestling Card Number(Required)

School/Organization Name

Birth Date

Weight

Grade

T-Shirt Size

Emergency Information

Emergency Contact Name(Required)

First Last

Relationship(Required)

Emergency Phone(Required)

Insurance Company(Required)

Policy Number(Required)

ID Number(Required)

Doctor's Name(Required)

First Last

Doctor's Phone Number(Required)

Medical Information

Allergies to medicine?

Yes

Which medicine/medicines is the athlete allergic to?

Does the athlete require medicine?

Yes

Which medicine/medicines does the athlete require?

List any significant illness or injuries that medical personnel should be aware of.

Camp Waiver

In consideration of my wrestler application for the BullTrained Wrestling Camp, held by BullTrained Wrestling LLC, being accepted and other valuable consideration, the receipt and sufficiency of which is acknowledged – with the understanding that participation in such camp can expose me to certain risk – for myself, my heirs, executors, and administrators hereby waive, discharge, and release any and all rights and claims for damages that I may have against BullTrained Wrestling LLC, or its officers, agents, representatives, successors and/or assignees, for any and all losses, damages, or claims that may be sustained or suffered by me in connection with my association with the BullTrained Wrestling Camps held by BullTrained Wrestling LLC, including, without limitation, my participation in the BullTrained Wrestling Camp, held by BullTrained Wrestling LLC.

Athlete's name(Required)

Name of parent or guardian.(Required)

Date(Required)

Parent's Waiver of Liability and Permission

Date(Required)

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