POWER HALF WRESTLING GRAPEVINE TOURNAMENT TEAM 2024-2025 SEASON
FEES: Used to cover tournament fees, referee costs, and Grape Vine League Fees (uniforms (if needed) are an additional cost. Amount due is payable in cash to Power Half Wrestling Academy COSTS: 1st child - $100, 2nd child - $75, 3rd child - $70, 4th child - $60
Parent/Guardian Name
First Name
Last Name
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Email
example@example.com
Phone Number
Please enter a valid phone number.
Participant Information - Standard Singlets are $45 and 2-Piece Singlets are $50
First and Last Name
Date of Birth
Uniform Required?
Type of Uniform
Size of Uniform
Child 1
Yes
No
Black Lightening Singlet
Blue Camo Singlet
Red Camo Singlet
Two Piece Lighting Singlet
YXS
YS
YM
YL
S
M
L
XL
Child 2
Yes
No
Black Lightening Singlet
Blue Camo Singlet
Red Camo Singlet
Two Piece Lighting Singlet
YXS
YS
YM
YL
S
M
L
XL
Child 3
Yes
No
Black Lightening Singlet
Blue Camo Singlet
Red Camo Singlet
Two Piece Lighting Singlet
YXS
YS
YM
YL
S
M
L
XL
Child 4
Yes
No
Black Lightening Singlet
Blue Camo Singlet
Red Camo Singlet
Two Piece Lighting Singlet
YXS
YS
YM
YL
S
M
L
XL
Authorizations
As the Parent/Guardian of the above mentioned child(ren) I authorize that he/she has my permission to participate in all Power Half Wrestling Academy Club activities. I assume all risks and hazards incidental to such participation, including transportation to and from any and all related activities; and I do hereby waive, release, and absolve, indemnify and agree to hold harmless Power Half Wrestling Academy Club directors, coaches, and volunteers. I also authorize and give permission to the staff of the Power Half Wrestling Academy Club to act in my behalf in obtaining medical care in the event of an accident or illness requiring professional medical care. I fully understand the above agreement and will not hold the Power Half Wrestling Academy Club staff responsible for any actions taken by them in obtaining the best medical care possible for my child/ward.
Name of Parent/Guardian
First Name
Last Name
Date
Signature
Team Contact:
For any questions or concerns please contact Stephanie Benedetti Cell Phone: 215-801-9340 or email:powerhalfwrestling@gmail.com
Submit
Should be Empty: