TDM Camp Registration

TDM Camp Registration 2014-03-19T15:07:29+00:00

Please fill out the registration form below and hit submit at the bottom. After submitting the form, you will be redirected to a PayPal page to pay the camp registration fee.

Which Camp Are You Attending? (required)

Wrestler's Name (required)

Address (required)

City (required)


Zip (required)

Parent(s) Name(s)(required)

Email (required)

Home Phone (required)

Emergency Phone (required)

Work Phone

Wrestler's Current Height (required)

Wrestler's Current Weight(required)

Age (required)

Medical Insurance Company

Policy Number

By checking this box you acknowledge and agree to the medical waiver below and that you are over 18 years of age.
My son/daughter has been examined by a physician in the last year and is in good health. I hereby authorize the Takedown Machine Wrestling Camp Staff to act for me, according to it's best judgment in any medical emergency, and I hereby waive and release the TDM Wrestling staff from any liability for injuries or illness incurred by my son/daughter while attending camp. All information I have provided on this application is accurate.

Comments or Questions

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