Maple Shade Youth Wrestling Registration Form

Full Name of Participant*

First NameLast Name

Date of Birth of Participant*

Date

Age of Participant*

Years of Experience (if any)

Gender*

Approximate Weight*

T-Shirt Size (Shirts will be ordered of size provided)*

Parent/Guardian Name*

Parent/Guardian Email Address*

example@example.com

Additional Email Address (Not Required)

example@example.com

Parent/Guardian Phone Number*

Please enter a valid phone number.

Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Medical Conditions or Allergies (if any)

Additional Notes or Special Needs

Medical Release*

By checking, I hereby authorize the Maple Shade Youth Wrestling Organization to make medical decisions for my child, during the 2025-26 season in the event of my absence or if I am unable to be contacted in the event of an injury or illness. I assume all financial responsibility for the care of my child. I hereby release, absolve, indemnity and hold harmless Maple Shade Youth Wrestling, its officers, organizers, sponsors, coaches and assistants in the event my child is injured or becomes ill as a result of participating in any practice, match, tournament, or event sponsored by the Maple Shade Youth Wrestling and release them from all claims.

Equipment Responsibiltiy*

By checking, I accept full responsibility for all equipment issued to my child. I will return the equipment in good condition at the end of the season or if requested by Maple Shade Youth Wrestling or my 75 dollar uniform deposit will be kept to replace or repair the items damaged or lost.

Sportsmanship and Code of Conduct*

By checking, I agree and will abide by the MSYW code of conduct. Good sportsmanship in the cornerstone of any sport. Profanity, verbal abuse, poor sportsmanship, throwing of equipment during a match or practice will not be tolerated. There will be bad calls and missed calls at some point of the season- it happens. We all lead by example, we all need to take the opportunity to talk with our wrestlers and kids win or lose and about being a good sport, shaking hands and looking forward to the next challenge. Poor behavior, poor sportsmanship will not be tolerated; we’re all here for our kids both as parents and coaches. We love the sport and we all want to see our kids grow, learn, compete and have fun, Outbursts or profanity, disrespect of other coaches, wrestlers, officials, or referees cannot and will not be tolerated by this organization. We all need to be a positive representative and influence for our town, team and kids.

Media Release

At times we my be posting pictures/videos of wrestlers and events on our website or social media accounts to showcase our athletes. By clicking this box, you are granting permission to possibly use photos of your child on these platforms.

Signature of Parent/Guardian*