Team Barracuda WC Registration

Team Barracuda WC Registration
Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Email*
example@example.com
Alternate Email
example@example.com
Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
School *
Grade *
Years of Experience *
AAU/USA Card #*
Permission to use Photographs/Videos *I grant to Team Barracuda Wrestling Club its representatives and employees the right to take photographs/videos of me and my property in connection with the above-identified subject. I authorize Team Barracuda Wrestling Club, its assigns and transferees to copyright, use and publish the same in print and/or electronically. I agree that Team Barracuda Wrestling Club may use such photographs/videos of me with or without my name and for any lawful purpose, including for example such purposes as publicity, illustration, advertising, and Web content.*

YESNO
Digital Signature *Please Enter Full Name*
Digital Signature *Please Enter Date*
Club Dues

Please make payment through Venmo, Cash app, or cash.

Venmo-@Teambarracudawc

Cash App-$TeamBarracuda
Should be Empty: