• Bella Mir Wrestling Camp Registration Form

    Hosted by Mississippi Queens Wrestling Club
  • Athlete Information

  • Gender*
  • Session Choice*
  • Parent/Guardian Information

  • Format: (000) 000-0000.
  • Emergency Information

  • Format: (000) 000-0000.
  • Format: (000) 000-0000.
  • MISSISSIPPI QUEENS WRESTLING CAMP

    RELEASE OF LIABILITY, ASSUMPTION OF RISK, HOLD HARMLESS AGREEMENT, AND MEDICAL AUTHORIZATION

    I, the undersigned parent/legal guardian of the participant named below, hereby give permission for my child to participate in the Mississippi Queens Wrestling Camp and all related activities, including but not limited to wrestling instruction, drills, practices, competitions, conditioning, recreational activities, and the use of equipment and facilities associated with the camp.

    I understand and acknowledge that participation in wrestling and camp-related activities involves inherent risks, including but not limited to serious bodily injury or illness. These risks may arise from physical contact with other participants, use of equipment, falls, strenuous activity, facility conditions, negligence of participants or others, and other known or unknown risks associated with athletic participation.

    I voluntarily assume all risks, both known and unknown, associated with my child’s participation in the Mississippi Queens Wrestling Camp and all related activities.

    In consideration of participation in the camp, I hereby release, waive, discharge, covenant not to sue, and agree to indemnify and hold harmless the Mississippi Queens Wrestling Club, camp hosts, clinicians, coaches, volunteers, staff members, sponsoring organizations, affiliates, facility owners, property landlords, representatives, agents, officers, directors, employees, and all other persons or entities associated with the camp from and against any and all claims, demands, causes of action, damages, losses, liabilities, costs, or expenses of any kind arising out of or related to participation in the camp, including claims arising from negligence to the fullest extent permitted by law.

    I further agree to exonerate, defend, indemnify, and hold harmless all aforementioned parties from any claims or liabilities brought by or on behalf of the participant, the participant’s family, heirs, estate, assigns, or any other party.

    I acknowledge that protective equipment, supervision, and instruction do not guarantee safety or prevent injury. I agree that my child will follow all camp rules, instructions, and safety guidelines provided by coaches, clinicians, and camp staff.

    I certify that the participant is physically fit, in good health, and able to safely participate in all Mississippi Queens Wrestling Camp activities. I am not aware of any medical condition, illness, injury, disability, or other health concern that would prevent or limit safe participation unless disclosed in writing prior to participation.

    I hereby authorize camp staff, coaches, directors, volunteers, licensed physicians, athletic trainers, emergency medical personnel, hospitals, and other qualified healthcare providers to provide or arrange reasonable and necessary medical evaluation, care, and emergency treatment for the participant in the event of illness or injury. I understand that reasonable efforts will be made to contact me prior to treatment whenever possible.

    I acknowledge and agree that I am solely responsible for any and all medical expenses, hospital charges, ambulance fees, physician fees, medications, or other healthcare costs incurred on behalf of the participant.

    This authorization and consent shall remain effective for the duration of the participant’s involvement in the Mississippi Queens Wrestling Camp and related activities.

    I acknowledge that I have carefully read this Release of Liability, Assumption of Risk, Hold Harmless Agreement, and Medical Authorization form, fully understand its contents, and sign it voluntarily as my own free act and deed. I understand that this document is legally binding upon me, my child, our heirs, executors, administrators, assigns, and family members.

  • MISSISSIPPI QUEENS WRESTLING CAMP

    PHOTO & MEDIA RELEASE

    I, the undersigned parent/legal guardian of the participant named below, hereby grant permission to the Mississippi Queens Wrestling Club and its representatives, agents, photographers, videographers, media outlets, sponsors, and affiliates to photograph, videotape, record, or otherwise capture the participant’s name, image, voice, likeness, statements, and participation during camp activities and related events.

    I understand and agree that these photographs, videos, recordings, and other media may be used for promotional, educational, advertising, fundraising, social media, website, news, print, digital, or other lawful purposes related to the Mississippi Queens Wrestling Club and its programs.

    I acknowledge that participation in the event constitutes consent and release of the participant’s name, image, and likeness for such purposes without compensation, inspection rights, or additional approval.

    I hereby release, discharge, and hold harmless the Mississippi Queens Wrestling Club, its officers, directors, coaches, volunteers, sponsors, affiliates, agents, and representatives from any and all claims, demands, or causes of action arising out of or related to the use of such photographs, videos, recordings, or other media.

    I understand that all media captured becomes the property of the Mississippi Queens Wrestling Club and may be used indefinitely unless otherwise prohibited by law.

  • By clicking “Submit" below, I acknowledge that I have read, understand, and voluntarily agree to the Release of Liability, Assumption of Risk, Hold Harmless Agreement, Medical Authorization, and Photo & Media Release provided above. I understand that submission of this registration form constitutes my electronic signature and agreement to all terms and conditions contained herein.

  • Registration Check-Out*

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        One-Day Camp Registration

        One-Day camp only, t-shirt not included

        $60.00$60.00
          
        2-Day Camp Registration

        Two-Day camp registration, t-shirt included

        $100.00$100.00
          
        Total
        $0.00$0.00
      • Venmo payment is also accepted (button may or may not be available below). Please include the name of your athlete in the description when submitting payment. Venmo: @MSQueens

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