Registration Application
Fill out the following form and click "print" when finished. Be sure to sign the Liability Release at the bottom and mail this form, including a non refundable deposit of $100 to:

Aggies Wrestling Camps

Attn: Brandon Totten
700 East Butler Avenue
Doylestown, PA 18901

Makes Checks Payable to “Aggies Wrestling Camps”.

NAME:
AGE:
PHONE:
ADDRESS:
CITY:
STATE:
ZIP:
SCHOOL NAME:
COACH:
E-MAIL:
ROOMATES NAME:
   

Check off the camp(s) you will attend:
  
North Carroll High School Day Camp, Hampstead, MD  $170
Intensive Camp, Doylestown, PA   R-$395, C-$330
Elementary Camp, Doylestown, PA   $250
Technique Camp, Doylestown, PA  R-$330, C-$280

 

Resident Camper
Commuter
  
Payment Information
Total camp(s) cost.................................................
Total amount enclosed.........................................
Check Number:
  

Medical Insurance Information Waiver
Insurance company:
Policy Number:

I hereby authorize the camp directors and staff to seek and receive the necessary medical and dental attention for your child while in attendance at the Aggies Wrestling Camps.

 

Liability Release
I, undersigned, individually and as a parent/ guardian of ____________________________ (camper) a minor, ask that he/she be admitted to participate in the Aggies Wrestling Camps.I do hereby agree to release, discharge, and hold harmless the Aggies Wrestling Camps, their owners, agents, and employees from allcauses, liabilities, damages, or claims in the course of the sport camp activities. I understand that a camper that does not abide by the rules and regulations of the camp or college is subject to dismissal without reimbursement or recourse.

Parent/Guardian signature required.

X_____________________________________________________