In-Season Registration

You must register online for the 2011-2012 PINnacle season. You can choose to pay online or with a check.
This registration will satisfy the Emergency Contact form also. NOTE: Home Phone must be numbers only(no dashes, hypens, etc.)

First Name:
Last Name:
Middle Initial:
Current USA Wrestling Card Number:
Address:
City:
State:
Zip:
Home Phone:
Cell Phone:
Work Phone:
DOB (dd/mm/yyyy):
Age:
Grade (2011-2012 School Year):
Weight (pounds):
Insurance Company:
Policy Number:
Parent or Guardian 1:
Parent or Guardian 2:
Email:
Emergency Contact Name:
Emergency Contact Number:
Class Applying For:
I Have Read the Disclaimer Below:

Disclaimer

By submitting this form, be aware that in participating in PINnacle Wrestling training camps and programs, you will be waiving and releasing all claims for injuries, arising out of these programs, that you or any other named participants may sustain. The terms also refer to parents and guardians as well as participants in the programs. In registering for these programs you agree to the following:
As a participant in these programs, I recognize and acknowledge that there are certain risks of physical injury, and I agree to assume the full risk of any injuries, damages or loss which I may sustain as a result of participating in any manner, in any and all activities connected with or associated with such programs. I further recognize and acknowledge that all athletic activities involving strenuous exertion or potential body contact are hazardous recreational activities and involve substantial risks and injury. I also give PINnacle Wrestling coaches or clinicians the right to seek medical attention for me if I am sick or injured. I am aware PINnacle Wrestling will not be responsible for medical or any other associated costs.

You also understand that PINnacle Wrestling may use your name, and/or picture, and any video for advertising purposes.