PLEASE PRINT
CHILD'S NAME_______________________________________BIRTHDATE____/____/____AGE_____
ADDRESS______________________________________________________________________________
CITY_________________________________STATE_________________________ZIP________________
PARENTS NAME(S)_____________________________________________________________________
HOME PHONE(____)_______________________________CELL(____)___________________________
EMERGENCY#(____)_______________________________CONTACT____________________________
EMAIL ADDRESS_______________________________________________________________________
YRS. WRESTLING_____CLUBS______________________SCHOOL_____________________________
MEDICAL/ALLERGIES__________________________________________________________________
I, the parent or guardian of the above-named child, hereby give my approval to their participation in any and all activities of the Spartans during the current season. I assume all risks and hazards incidental to the conduct of the activities and transportation to and from the activities. I do hereby release, absolve, indemnify and hold harmlessly the Spartans, the administrators, the officers, and/or all of them. In case of injury to my child, I hereby waive all claims against the sponsors, officers, or any administrator appointed by them, and also give my permission for any necessary emergency treatment to be administered. I will furnish a birth certificate to the above-named child upon request of association officials.
PARENT/GUARDIAN SIGNATURE______________________________________________________
I do____I do not____have medical/accidental insurance coverage.
Insurance Company Name_________________________________________________________________
Group Number__________________________________Policy Number____________________________
Each family is required to volunteer for one or more of the following activities
Coach____Team Parent____Mat Setup/Takedown____Team Pictures____Timer____Fund Raising____
Refreshment Stand____Publicity/Newspaper____Clothing____Board of Directors____
Please Circle Clothing Sizes: (Whatever size you choose, will be the size you are given. Exchanges can no longer be made.)
Sweat Pants:
Youth S (6/8) M (10/12) L (14/16) Adult S M L XL
Sweatshirts: Youth S (6/8) M (10/12) L (14/16) Adult S M L XL
T-Shirts: Youth S (6/8) M (10/12) L (14/16) Adult S M L XL
Cost: $65.00 for 1 Wrestler, $110.00 for 2 Wrestlers, $150.00 for 3 Wrestlers in the same immediate family.
Plus additional cost per wrestler for singlets. Please bring a copy of Birth Certificate to registration.
Make Checks Payable to: Spartan Youth Wrestling Club
Mail Payments to: Spartan Youth Wrestling Club
958Woodbourne Drive, Southampton, PA. 18966
Do not write below line-------------------------------------------------------------------------------------------------------------------------------
PAID: $______________ CASH ( ) CHECK ( ) #________
SINGLET DEPOSIT RECEIVED: YES ( ) or NO ( )
All deposits will be reimbursed at the end of the season
I have read and understand the Registration Form, Singlet Return and Volunteer Agreement
___________________________________________________
Spartan Youth Wrestling Club
Membership Application
WWW.SPARTANYOUTHWRESTLINGCLUB.COM
RECEIPT
CHILD’S NAME: ________________________________________
PAID: $______________ CASH ( ) CHECK ( ) #_____________
SINGLET DEPOSIT: YES ( ) or NO ( )
RECEIVED BY: _________________________________________
DATE: _______________________
Singlet Return :
Your $35.00 Singlet deposit will be reimbursed by April 2008. There will be additional deposit of $30.00 if your child makes the Varsity team this season. This is to cover the cost of the new Singlets. This additional deposit will be collected before your child is given a Varsity Singlet. There will be a Singlet return night scheduled before the above date. This date is to be determined. If the Singlet is not returned prior to April no deposit will be returned, and you will have purchased the Singlet. A new deposit must be given for the next season. If you cannot make the Singlet return night, the Singlets may also be given back at the Awards banquet and a check will be mailed to your address. We will no longer except Singlet returns after April 2008, which will be the conclusion of the season. If you have any questions or comments please email: Spartansclub@AOL.com.
Thank you.
