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    2010 Summerville Takedown Club Registration

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    grnwave03
    The Summerville Takedown Club registration form collects information such as name, contact details, medical information, and payment for $60 to register for the 2010 wrestling season. Parents can indicate if they are interested in coaching or being a team mom. The form requests a wrestler's weight, experience level, emergency contacts, insurance info, and how the registrant heard about the club.

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    2010 Summerville Takedown Club Registration

    Uploaded by

    grnwave03
    103 views2 pages
    The Summerville Takedown Club registration form collects information such as name, contact details, medical information, and payment for $60 to register for the 2010 wrestling season. Parents can indicate if they are interested in coaching or being a team mom. The form requests a wrestler's weight, experience level, emergency contacts, insurance info, and how the registrant heard about the club.

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    The Summerville Takedown Club registration form collects information such as name, contact details, medical information, and payment for $60 to register for the 2010 wrestling season. Parents can indicate if they are interested in coaching or being a team mom. The form requests a wrestler's weight, experience level, emergency contacts, insurance info, and how the registrant heard about the club.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as DOCX, PDF, TXT or read online from Scribd
    Flag for inappropriate content
    Download as docx, pdf, or txt
    103 views2 pages

    2010 Summerville Takedown Club Registration

    Uploaded by

    grnwave03
    The Summerville Takedown Club registration form collects information such as name, contact details, medical information, and payment for $60 to register for the 2010 wrestling season. Parents can indicate if they are interested in coaching or being a team mom. The form requests a wrestler's weight, experience level, emergency contacts, insurance info, and how the registrant heard about the club.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as DOCX, PDF, TXT or read online from Scribd
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    Download as docx, pdf, or txt
    of 2

    SUMMERVILLE TAKEDOWN CLUB

    Registration Form - 2010


    $60 Registration Fee
    Make Checks Payable to Summerville
    ($40 for each sibling) Please Print Clearly Takedown Club

    Cash $______Check
    #_______/$_____

    Contacted: ______________

    Signed Waiver: Yes / No

    Wrestler's First Name _______________________________

    Wrestler's Last Name _______________________________

    Birthday _________/_________/__________

    Age ____

    Grade in School _____

    Name of School (i.e. Beech Hill ES) _______________________________

    Weight: ______

    Years of Past Experience _______

    Parent's First Names (Mom & Dad) _______________________________

    Parent's Last Name _______________________________

    Home Phone Number______________________________

    Work or Cell Phone Number __________________________________________

    E-Mail Address _____________________________________________________

    Home Mailing Address ________________________________________________


    ________________________________________________

    Emergency Contact (Name and relation) ______________________________________ (Phone Number) _________________

    Allergies: Please list and explain reactions/side effects


    Medical: (i.e. Asthma) ________________________________________
    Food: (i.e. Peanuts) __________________________________________

    DAD - Interested in Coaching? _______________________________

    MOM - Interested in Team Mom? _______________________________

    Health Insurance Company Name _______________________________

    How did you find out about the Takedown Club Sign-Ups? _______________________________ (Post & Courier, S'ville Journal Scene,
    School, Soccer, Football, Friends, etc.)

    T-Shirt Size for Wrestler?


    Youth – S (6-8) M (10-12) L (14-16)

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