Help Links ?
Resend Confirmation
ADULT WRESTLING-FALL 2022
WRESTLER INFORMATION
Please check appropriate box
Adult Greco 4 Sessions ($299.00)
attend any of the 4 sessions this fall
Adult Greco All Sessions ($499.00)
all 7 sessions this fall
Wrestler Name
*
Weight
*
Any information we should know about, including experience
Email
*
Confirm Email
*
Email #2 (optional)
Street Address
*
----------------------
State
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
AA
AE
AP
Cell Phone
*
Cell Phone #2 (optional)
Medical Waiver
*
I hereby voluntarily permit me or my child to participate in activities at Top of the Podium or TOP 24/7. I understand and fully accept there are risks involved in sports, and that accidents and injuries are common and are ordinary occurrences in sports. I hereby agree to accept any and all risks of injury or death, and verify this statement by checking the box below. As consideration for being permitted by TOP to participate in these activities, I hereby release and hold harmless the TOP staff, volunteers and designated coaches from all liability, and from all actions or claims that I or my child now or hereafter have for damage or injury to me or my child, or to any person or property, resulting from the negligence or other acts of any employees or volunteers in connection with me or my child’s participation. I further agree that this waiver, release and assumption of risks is to be binding on the heirs and assigns of the undersigned.
I further agree to indemnify and to TOP (its officers, employees, agents and volunteers) free and harmless from any loss, liability, damage, cost or expense which they may incur as a result of any injury and/or property damage that I or my child may cause or sustain while participating in this activity.
In the event of a medical emergency, I grant permission for TOP volunteers to administer first aid or secure medical treatment for my athlete, provided they are unable to communicate with me, and according to their best judgment. I also hereby give permission to TOP staff and volunteers to disclose the information contained on this form to medical personnel. I agree to pay all medical, hospital, or other expenses which my child or I may incur as a result of such treatment. TOP does not provide any medical or other insurance protection or benefits for those who participate in their programs.
I HAVE CAREFULLY READ THIS RELEASE AND FULLY UNDERSTAND ITS CONTENTS. I AM AWARE THAT THIS IS A RELEASE OF LIABILITY AND A CONTRACT BETWEEN ME AND TOP OF THE PODIUM, INC. ACCORDING TO MY OWN FREE WILL.
I have read and agree to the terms above.
Add Another Another Participant
Almost done. Where should we send the confirmation?
Name on Card
*
Email
*
Submit
Event Registration Software by RegFox