ROY HALL ATTACK CAMP "Preparing wrestlers ... - Team Rhino LLC

Roy Hall's Michigan Attack Camp Registration Form
Name:_______________________________________________________________________
Club \ High School: _________________________________________________
Phone: ________________________________Email: __________________________________
Grade: __________Weight :____________ Experience: First time Y/N ___ Years__________
Wrestling honors:________________________________________________________________
Emergency Contact: _____________________________________ Phone_______________________
USA Wrestling card required for participation ($35) and can be purchased at the door or online at themat.com
If you do not have a current USA card you may purchase a NC USAW league pass for $10 at the door.
Camp Schedule
Registration on 6 July will be from 7‐8:30 am. Doors will open each day at 8:30 am, instruction begins at 9am sharp.
Lunch will be from 12‐12:45pm. Live wrestling will be from 1‐2pm.
Session Selection [Circle your selection(s)]
All Three Sessions, July 6‐8 th $75
1st Session Monday, July 6 th $30
2nd. Session Tuesday, July 7 $30
3rd. Session Wednesday, July 8 th $30
Total Amount ______
For more information please do not hesitate to call
Coach DeWeese 910‐273‐2806 or 920‐429‐2800 (school) or
Marty Bartram 910‐824‐0024 (rhinocoach@rhinowrestling.org)
PLEASE SEND THIS FORM WITH
PAYMENT TO:
Coach DeWeese
Jack Britt High School
7403 Rockfish Rd.
Fayetteville, N.C. 28306
Checks should be made out to
Jack Britt High School
Concessions for breaks and lunch
will be available in the Atrium
AUTHORIZATION AND RELEASE OF ALL CLAIMS:
It is expressly agreed that all of the use of Jack Britt High School and its facilities shall be undertaken by the parent/guardian at his or
her risk. It is further agreed that the Rhino Wrestling Club, Raptor Wrestling Club and Jack Britt High School shall not be liable for any
injuries or damages to parent/guardian or wrestler, nor the subject of any claim, injury, or damages, whatsoever, including but not
limited to damages resulting from act of active or passive negligence on the part of Rhino Wrestling Club, Raptor Wrestling Club and
Jack Britt High School its successors or its officers or agents.
It is specifically agreed that Rhino Wrestling Club, Raptor Wrestling Club and Jack Britt High School shall not be responsible or liable to
the parent/guardian or wrestler for articles lost or stolen in the school. Rhino Wrestling Club shall not be responsible or liable for loss or
damage to any other property of parent/guardian or wrestler including their automobile and contents thereof.
It is also agreed that any damages to the school facilities or property or property of any parent/guardian or wrestler by any other
parent/guardian or wrestler, is the sole responsibility of the offending parent/guardian or wrestler. I have identified all medical problems
that the Rhino Wrestling Club, Raptor Wrestling Club and Jack Britt High School should be aware of and have provided all special
instructions on the Registration Form. I understand that photographic, video and/or other images of my child may be obtained and used
in the media, on Rhino Wrestling Club website, the Jack Britt Wrestling Team website or in other Rhino Wrestling Club promotional and
publicity materials at the discretion of Rhino Wrestling Club, and that if I do not wish for my child's image to be used for these purposes
I must request so in writing.
I expressly agree that this release, waiver, and indemnity agreement is intended to be as broad and inclusive as permitted by the laws
of the State of North Carolina. This release is an agreement between the parties. This agreement and the terms of this release are
contractual and not a mere recital.
I give permission for _________________________________ (Child’s Name) to participate in the Rhino Wrestling Club, Raptor
Wrestling Club and Jack Britt High School Wrestling Camp.
I ___________________________ (Parent / Guardian signature) certify that I am the managing conservator of this child or children,
am authorized to sign this waiver, and accept the terms of this Agreement.
Dated____________________________________________