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Minooka Wrestling Club
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Athlete's Name
*
First
Last
Parent Agreement or
Gender
*
Male
Female
Athlete's Date of Birth
*
MM/DD/YYYY
School Name
*
Grade
*
Athlete's Weight
*
Years of Experience
*
Singlet Size
*
— Select Choice —
YXS
YSM
YMD
YLG
YXL
XS
SM
MD
LG
XL
Parent Name 1
*
First
Last
Parent Name 2
First
Last
Address
*
Email
*
Phone Number
*
Medical History
*
Does the athlete have any allergies or medical conditions that we need to be aware of.
Emergency Contact (Name & Phone#)
*
Membership
*
Little Ninjas ($100)
IKWF Season ($200)
IKWF Season no singlet ($150)
Sports interested in
Football
Baseball
Soccer
Softball
Volleyball
Basketball
Track and field
Other
Permission & Agreement
*
I agree and give my permission
I understand and acknowledge that Training involves risk of serious injury, including permanent disability and death. I understand and agree that the Hosts are not responsible for property that is lost, stolen, or damaged while in, on, or about the premises.
In consideration of my participation at Minooka Wrestling Club provided by KJ Minor and the related training, competition, and my use of the equipment and facilities (hereinafter the “Training”), I expressly agree and contract, on behalf of myself, my heirs, executors, administrators, successors and assigns, that KJ Minor (hereinafter the “Host”), and the Hosts’ insurers, heirs, agents, successors, assigns, and associates shall not be liable for any damages arising from personal injuries (including death) sustained by me, or my guest(s) in, on, or about the premises, or as a result of the use of the Training, regardless of whether such injuries result, in whole or in part, from the negligence of the Hosts.
By the execution of this agreement, I accept and assume full responsibility for any and all known and unknown risks, injuries, damages (both economic and non-economic), and losses of any type, which may occur to me as a result of the Training, and I hereby fully and forever release and discharge the Hosts, and the Hosts’ insurers, heirs, agents, successors, assigns, and associates, from any and all claims, demands, damages, rights of action, or causes of action, present or future, whether the same be known or unknown, anticipated, or unanticipated, incident to, resulting from, arising out of, or related to the Training.
I expressly agree to indemnify, financially provide for the defense of, and hold the Hosts, and the Hosts’ insurers, heirs, agents, successors, assigns, and associates (hereinafter the “Releasees”) harmless against any and all claims, demands, damages, rights of action, or causes of action, of any person or entity, that may arise from any and all injuries, including death, losses, or damages sustained by me or my property incident to, resulting from, arising out of, or related to the Training, whether arising in whole or in part from the negligence of the Releasees or otherwise, to the fullest extent permitted by law.
I agree to be solely responsible for safety and wellbeing of myself. I agree to comply with all rules imposed by the Hosts. I agree to conduct myself in a controlled and reasonable manner at all times, and to refrain from Training in a manner inconsistent with instruction, and the intended design and purpose.
I HAVE READ THE FOREGOING WAIVER AND RELEASE OF LIABILITY AND VOLUNTARILY EXECUTED THIS DOCUMENT WITH FULL KNOWLEDGE OF ITS CONTENT.
Minor’s Parental Consent
I hereby certify that I am the adult parent or guardian of the minor child set forth above (hereinafter the “Minor”) who is under the age of eighteen years. I am at least eighteen years of age and have carefully read and freely signed this Waiver, Release, Assumption of Risk, and Indemnification set forth above (hereinafter the “Agreement”). I consent and agree, on behalf of myself, the Minor, and any of the Minor’s parents, legal guardians, heirs and assigns, to the terms of the Agreement to the fullest extent allowed by law. I further certify that I have the authority to enter into this Agreement to the extent set forth above.
Name of legal parent or guardian
*
First
Last
Submit
Note: payment will be taken at first practice.