Wrestler Participation Request

Wrestler Participation Request

Wrestler Information
School Name*
Name*

First NameLast Name
Email*
example@example.com
Phone Number*
Please enter a valid phone number.
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Weight Class*
Year*
T-Shirt Size*

Emergency Information
Who should we contact in case of emergency?*

First NameLast Name
Emergency Contact Phone*
Please enter a valid phone number.
What is this contact's relationship to you?*
For example: Parent, Sibling, etc.
Name of Parent or Guardian*

First NameLast Name
Phone Number of Parent or Guardian*
Please enter a valid phone number.
Health Insurance Provider*
Name of the Health Insurance Company of Wrestler
Health Insurance Phone Number*
Please enter a valid phone number.
Doctor Name*

First NameLast Name
Doctor Phone Numer*
Please enter a valid phone number.
Dentist Name*

First NameLast Name
Dentist Phone Number*
Please enter a valid phone number.
Do you have any medical conditions or allergies?*

YesNo
Please note all medical conditions or allergies below:

Waiver
Code of Conduct:

As a participant in the Yeshiva Wrestling Association Henry Wittenberg Wrestling Tournament, the following points are fully understood:
- Adherence to the total program is required for each participant.
- Participants will abide by all instructions given by staff and will participate in the Program to the best of his ability.
- Participants are responsible for any damage that they may cause to the property of The Frisch School, the Yeshiva Wrestling Association, or third parties.
- Throughout the entire tournament, participants must adhere to the high standards of religious observance expected at a YWA event.
Date*

YearMonthDay
Date
Each wrestler must have a waiver signed by his parent or legal guardian.

Wrestlers without this waiver will not be permitted on the mat.

There are no exceptions to this policy.

The parent waiver can be found here: Participant-guardian-waiver

The waiver can be filled out separately.

If you encounter any issues, contact us at tamar@ywa.org.
Signature*

Clear
Should be Empty: