Wrestling Camp Flier Due A.S.A.P.

Twinsburg Wrestling Camp Registration

June 6-10, 2011

Cost:  $125.00

Grades: 1-12

Instruction by:

Rick Deubel: Assistant Coach University of Buffalo

Anthony Ralph: Assistant Coach Notre Dame College

Tom Straughn:  Assistant Coach Notre Dame College

Jamie Milkovich:  Head Coach Maple Heights

Special Guests:  Mike Baker (State Champ THS)     Mike Labry (2X state placer THS)

Theme:  Education and Wrestling:  Making the Right choices that bring success in the sport and in life.

Camp will be comprised of but not limited to:  warm-ups, drilling, learning technique, and sparring with partner

Please separate bottom portion and return with a check made out to the Twinsburg Wrestling Club.
OR Paste to your word processing tool. 

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Athlete’s Name:  ____________________________________________________

Address:  __________________________________________________________

Phone:  ____________________________________________________________

Emergency Contact:  __________________________________________________

If parent/guardian cannot be reached contact:  _______________________________

Family Physician:  ____________________________________________________

Family Dentist:  ______________________________________________________

Special Needs/Concerns:  ______________________________________________

Waiver And Release: In consideration of my application being accepted, I, intending to be legally bound,

do hereby, for myself, my heirs, executors and administrators, waive, release and forever discharge and

all rights and claims for damages, which I may have or which may hereafter accrue to me against and coaches, instructors, The Twinsburg Wrestling Club, or Twinsburg City  Schools for any or all damages which may be sustained or suffered by me in connection with my association to Twinsburg Wrestling Camp.  Further, we the parent(s) or legal guardian(s) have been informed that there is an assumption of risk when anyone participates in the sport of wrestling.

Signed______________________________ Signed_________________________

(Parent or Guardian) (Applicant)