2018 Thomas More Wrestling Camp

Mon June 24:
Session One	x	1:00pm - 3:00pm
Session Two	x	4:30pm - 6:30pm
x
Tues June 25:
Session One		1:00pm - 3:00pm
Session Two		4:30pm - 6:30pm
x
Cost:
$25 per session
$100 to attend all sessions

XX

For questions, please contact Jason Russell at 614-495-7230 or russelj@thomasmore.edu.

June 24 Session One: 1:00pm - 3:00pmJune 24 Session Two: 4:30pm - 6:30pmJune 25 Session One: 1:00pm - 3:00pmJune 25 Session Two: 4:30pm - 6:30pm

Total Registration:

Camper Information

Camper Name*

First NameLast Name

Age

Grade in Fall 2019

School

Parent/Guardian Information

Name*

First NameLast Name

Mailing Address*

Street Address

Street Address Line 2

CityState

Zip Code

Phone Number

Area CodePhone Number

Email Address*

example@example.com

Emergency Information

Emergency Contact's Name*

First NameLast Name

Contact Number*

Area CodePhone Number

List any medical condition(s) the staff should be aware of

Insurance Provider*

Policy Number*

Participation Waiver

We, the undersigned, for ourselves, our heirs, and executors, waive, release and forever discharge Thomas More University and the TMU Wrestling Camp, its staff, employees and representatives from all rights and claims for damages, injury or loss to person or property which may occur during participation in camp activities or while at camp.

We certify that the applicant is in good physical health and has permission to participate in the TMU Wrestling Camp and hereby authorize the employees and agents of said camp to act according to their best judgement in any situation requiring medical attention. All costs incurred are the responsibility of the parent/guardian. A copy of this authorization shall be considered as valid and effective as the original. By typing in your signature you certify that you have read and agreed to the above terms.

Parent/Guardian Signature*

First NameLast Name

Credit Card (preferred)Check

Total Registration Fee*

Invoice for Authnet

Make check payable to Thomas More Wrestling Camp and bring to first day of camp or mail to:

Thomas More University Wrestling Camp

333 Thomas More Parkway

Crestview Hills, KY 41017

Payment

USDDescription

Credit Card

First Name

Last Name

Credit Card Number

Security Code

Expiration Month

Expiration Year

Billing Address

Street Address

Street Address Line 2

City

State / Province

Postal / Zip Code

Country

2019 Thomas More Wrestling Camp Registration