Wrestler's Name *

First Name

Last Name

Father/Guardians Name

First Name

Last Name

Father's Phone

(###)

###

####

Father/Guardians Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Mother/Guardian's Name

First Name

Last Name

Mother's Phone

(###)

###

####

Mother's Address if different from above

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Do you have health insurance? *

Yes

No

Emergency Contact Name

First Name

Last Name

Emergency Contact Phone

(###)

###

####

Medical Release Statement: Please Choose one *

Option 1: If my child needs medical attention, it is my wish that I be contacted BEFORE any medial procedures are taken on my child, unless immediate treatment is necessary to have my child's life or prevent injury

Option 2: If my child needs medical treatment while participating, it is my wish that the treatment be started WHILE efforts are being made to contact me. So that treatment is not delayed, I consent to any medical procedures that the physician believes necessary on the understanding that efforts to contact me will continue to be made. I accept responsibility for all costs related to such treatment.

You hereby release and agree to hold harmless Tampa Bay Tiger Wrestling Club (TBTWC), its Coaches, Board of Directors, team chaperones and other members and volunteers and any facility that TBTWC utilizes, from any liability arising from any injury to a wrestler(s) or any family member while participating in any way to the TBTWC wrestling program, including practices or other related activities while using designated facilities. You grant this release on behalf of yourself, the wrestler(s) any other person responsible for or representing the wrestler(s) in consideration of the benefits from participating in and becoming a member of of the Tampa Bay Tiger Wrestling Club. *

Yes I, the Parent/Legal Guardian, agree to the release form presented to me

Tiger Wrestling Club Web/Photo Release

I, parent/legal guardian give Tampa Bay Tiger Wrestling Club permission to post my wrestler's pictures and tournament results on their social media pages and website.

Yes I, the Parent/Legal Guardian agree to social media and website photography release. Including, but not limited to, tournament results

Today's Date

MM

DD

YYYY