Deptford Junior Wrestling

Number of Wrestlers to Register

Wrestler Name

First NameLast Name

Date of Birth

Date

Gender

Medical Information & Health History

Please list any current medications, known allergies (food/drug/skin), and any physical or mental health conditions we should be aware of. If none, please type 'N/A'.

Wrestler Name (2nd Wrestler)

First NameLast Name

Date of Birth (2nd Wrestler)

Date

Gender (2nd Wrestler)

Medical Information & Health History (2nd Wrestler)

Please list any current medications, known allergies (food/drug/skin), and any physical or mental health conditions we should be aware of. If none, please type 'N/A'.

Wrestler Name (3rd Wrestler)

First NameLast Name

Date of Birth (3rd Wrestler)

Date

Gender (3rd Wrestler)

Medical Information & Health History (3rd Wrestler)

Please list any current medications, known allergies (food/drug/skin), and any physical or mental health conditions we should be aware of. If none, please type 'N/A'.

Wrestler Name (4th Wrestler)

First NameLast Name

Date of Birth (4th Wrestler)

Date

Gender (4th Wrestler)

Medical Information & Health History (4th Wrestler)

Please list any current medications, known allergies (food/drug/skin), and any physical or mental health conditions we should be aware of. If none, please type 'N/A'.

Details for 5 or More Wrestlers

Include Name, DOB, and Gender for each child not listed above.

Medical Information & Health History (5 or more Wrestler)

Please list any current medications, known allergies (food/drug/skin), and any physical or mental health conditions we should be aware of. If none, please type 'N/A'.

Parent/Guardian Name

First NameLast Name

Phone Number

Please enter a valid phone number.Format: (000) 000-0000.

Email

example@example.com

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Deptford Junior Wrestling WAIVER AND RELEASE OF LIABILITY / HOLD HARMLESS AGREEMENT

1. ASSUMPTION OF RISK

I, the undersigned participant (or legal guardian if under 18), acknowledge that wrestling is a physically demanding and potentially dangerous sport. I understand that participation in wrestling, including training, sparring, conditioning, and competition, exposes me to the risk of serious injury, including but not limited to:
• Sprains, strains, fractures, and dislocations
• Head injuries, including concussions
• Skin infections and communicable diseases
• Permanent disability or death

I knowingly and voluntarily assume all risks associated with participation, whether known or unknown, and accept full responsibility for any injury or damage I may sustain as a result of my involvement with this wrestling gym.

2. RELEASE AND HOLD HARMLESS

In consideration of being allowed to participate in any wrestling-related activities at or through Deptford Junior Wrestling (the “Gym”), I, on behalf of myself, my heirs, assigns, personal representatives, and next of kin, hereby:
• RELEASE, WAIVE, AND FOREVER DISCHARGE Deptford Junior Wrestling, its owners, coaches, trainers, employees, volunteers, agents, sponsors, and affiliated organizations from any and all liability, claims, demands, causes of action, or expenses (including attorney’s fees), arising out of or related to any loss, damage, injury, or death that may be sustained while participating in Gym activities, regardless of fault or negligence.
• AGREE TO INDEMNIFY AND HOLD HARMLESS Deptford Junior Wrestling and its representatives from any claim, lawsuit, or liability made or incurred as a result of my participation, whether caused by the negligence of the Gym or otherwise.

3. MEDICAL TREATMENT

I authorize the Gym to obtain emergency medical treatment on my behalf in the event of injury or illness. I understand that I am solely responsible for all medical costs arising from any such incident.

4. RULES & CONDUCT

I agree to abide by all Gym rules and instructions given by coaches and staff. I understand that failure to follow safety guidelines or engage in reckless behavior may result in immediate termination of participation without refund.

5. MEDIA RELEASE (optional)

I grant permission for the Gym to use photographs or video of me taken during training or events for promotional purposes, unless I opt out in writing.

⸻

I HAVE READ AND UNDERSTAND THIS RELEASE OF LIABILITY AGREEMENT. I FULLY UNDERSTAND ITS TERMS AND THAT I AM GIVING UP SUBSTANTIAL RIGHTS BY SIGNING IT. I SIGN THIS AGREEMENT FREELY AND VOLUNTARILY.

Sign waiver and release of liability agreement Parent/Guardian Signature:

Deptford Junior Wrestling Code of Conduct

(Based on Deptford Township Ordinance 18.01)

Purpose

Deptford Junior Wrestling is committed to providing a safe, positive, and respectful environment where athletes can learn, grow, and enjoy the sport of wrestling. This Code of Conduct sets the standards of behavior expected from athletes, parents/guardians, coaches, and spectators.

By signing below, I acknowledge that I have read, understand, and agree to uphold this Code of Conduct.

Expectations for Everyone

Respect – Treat all players, coaches, officials, and spectators with courtesy and dignity.

Sportsmanship – Win with humility, lose with grace. Encourage fair play at all times.

Safety First – Never engage in behavior that endangers others physically or emotionally.

Positive Support – Encourage all athletes. No negative comments toward wrestlers, coaches, or officials.

Zero Tolerance – Violence, threats, bullying, or harassment of any kind will not be tolerated.

Prohibited Conduct (and Consequences)

Per Deptford Township Ordinance 18.01, the following actions will result in disciplinary action, including bans from events:

Physical altercations: Fighting, scuffles, or threats → 12-month ban from all youth sports events.

Entering the competition area to confront others: Verbally or physically confronting coaches, players, or officials → 12-month ban.

Verbal abuse: Obscene/profane language, racial/ethnic/sexual slurs, or derogatory remarks → Up to 12-month ban and additional team discipline.

Throwing objects: Tossing or placing items on the mat or competition area → 12-month ban and possible additional penalties.

Expectations by Role

Athletes

Give 100% effort in practice and competition.
Follow instructions of coaches and officials.
Show respect to teammates, opponents, and yourself.
No bullying, hazing, or disrespectful behavior.

Parents/Guardians & Spectators

Support all athletes in a positive manner.
Refrain from coaching from the sidelines.
Respect officials’ decisions.
Address concerns with coaches or board members privately, not during matches.

Coaches

Serve as role models of integrity, patience, and respect.
Place the well-being of athletes above winning.
Communicate with parents respectfully and promptly.
Enforce this Code of Conduct fairly and consistently.

Sign Cod of Conduct Agreement Parent/Guardian Signature:

Name

First NameLast Name