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Please Enter a Membership Type in the box. Type 1 = All Inclusive, $400.00 :: Type 2=Monthly, $75.00 :: Type 3=One-A-Week, $200.00
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Today's Date
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Wrestler's Name
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Home Phone xxx-xxx-xxxx
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Cell Phone xxx-xxx-xxxx
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Additional Phone xxx-xxx-xxxx
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Parent/Legal Guardian
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Mailing Address
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Apt. / Suite
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City
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State
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ZIP
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Email
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Emergency Contact Name
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Emergency Contact Number
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Date of Birth
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Age
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Grade In School
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School District / High School Team
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Current Weight
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Years of Wrestling Experience
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Any physical or mental conditions the Pride Wrestling should be aware of?
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Current Medications (if any)
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I/we, the undersigned, individually and as a parent/guardian of the above listed, a minor, ask that he/she be admitted to participate in the sports events sponsored by Pride Wrestling club. I do hereby agree to release, discharge and hold harmless all parties involved, their owners, agents, Owners of property and building, any and all schools and school districts where events are held ,Pride Wrestling Club and it’s coaches, volunteers, and employees from all liabilities, damages, claims or demands whatsoever on account of any injury or accident involving the said minor arising out of the minor’s attendance at the sport events or in the course of competition and/or activities held in connection with the sport events. I also give permission for my child to be photographed in relations that the photographs may be used for Pride Wrestling promotional purposes.
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Parent/Legal Guardian Electronic Signature
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Parent/Legal Guardian Electronic Signature
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