Manalapan Youth Wrestling

Manalapan MatRats

 

Manalapan Wrestling Club

Please make checks payable to:  Manalapan Wrestling Club      Paid Online:      yes       no

Wrestler’s Name: ________________________________________________________________

Age: ______  DOB: ________________ Grade: ______  Years of Experience: ______

Address: ________________________________City:     _______________________________                

Name of Parent or Guardian: __________________________________________________Phone:________________

CLEAR AND LEGIBLE email address:

_______________________________________________________

 

WAIVER, RELEASE AND AUTHORIZATION

I hereby acknowledge that participation by the child listed above in the Manalapan Wrestling Club (MWC) and related activities is at my sole discretion and judgment as the parent or guardian of the child. I understand that participation in the MWC involves inherent risk of physical injury. I, on behalf of my child, hereby assume all such risk. I hereby release and agree to hold harmless Manalapan High School (MHS), Manalapan Englishtown Regional Schools (MERS) and the Manalapan Wrestling Club, including its founders, Board and representatives, from all and any claims, actions, damages and liabilities for personal injury or damage relating to or arising out of any MWC activity which may be suffered by the child named above. In case of injury or illness to the child named above requiring immediate medical attention, I hereby authorize the representatives of MWC to act for me in any medical emergency in accordance with their best judgment, including 911 emergency care if deemed necessary or appropriate. I understand that any and all charges resulting from this medical treatment will be billed to me at my home address or to my medial insurance carrier. I further understand that the MWC, MHS and MERS are not responsible for lost or stolen property. I understand that this waiver, release and authorization is to be governed by and constructed under the laws of the state of New Jersey, without giving effect to its conflict of laws principles, and intended to be as broad and inclusive as permitted by the laws of such state. I agree that if any portion of this waiver, release and authorization is held invalid, the remainder of the waiver, release and authorization will continue in full force and effect. I further affirm that the venue for any legal proceedings shall be in New Jersey.

 

 

_______________________________     _____________     _____________________________

      Signature of Parent of Guardian                    Date                  Print Name of Parent or Guardian

Contacts:  manalapanyouthwrestling@gmail.com