PWA Registration Page

Parent First Name*

First

Parent Last Name*

Last

Address*

Street Address Address Line 2 City State ZIP Code

Email*

Enter Email Confirm Email

Parent's Cell Phone*

Emergency Number

Wrestler Information

What PWA Session are you registering for?*

What Elite session are you registering for?*

What WCWP session are you registering for?*

Wrestler's First Name*

First

Wrestler's Last Name*

Last

Wrestler's Age*

Please enter a number from 6 to 18.

Wrestler's Current Weight (Approx)*

Please enter a number less than or equal to 300.

Wrestler's Year of Experience*

Please enter a number less than or equal to 12.

Will this wrestler train year-round?*

Yes
No

If no, then how many months per year does he plan to train?

USAW or AAU Card #*

All wrestlers MUST have a valid USAW or AAU card to train at PWA. Get your USAW card or get your AAU Card. The USAW card is about $30 and the AAU is around $20. However, if you plan to compete in off-season tournaments or attend weekend clinics, you will need the USAW card, so we recommend you purchase that one.

Would you like to register a sibling?*

Yes
No

Please e-mail Nick if you need to register more than 2 siblings.

Wrestler 2 Information

What PWA Session are you registering wrestler 2 for?*

What Quest Session are you registering wrestler 2 for?*

What Elite session are you registering wrestler 2 for?*

First Name of Wrestler 2

First

Last Name of Wrestler 2

Last

Age of Wrestler 2

Please enter a number from 6 to 18.

Weight of Wrestler 2 (approx)

Please enter a number less than or equal to 300.

Year of experience for Wrestler 2

Please enter a number less than or equal to 12.

Will wrestler to train year-round?*

Yes
No

If no, then how many months per year does he plan to train?

USAW or AAU Card # for Wrestler 2*

All wrestlers MUST have a valid USAW or AAU card to train at PWA. Get your USAW card or get your AAU Card. The USAW card is about $30 and the AAU is around $20. However, if you plan to compete in off-season tournaments or attend weekend clinics, you will need the USAW card, so we recommend you purchase that one.

Waiver

Waiver Release: Check off the box below to accept the terms of the waiver and release.

I accept

Release, Waiver and Indemnity, I agree, on behalf of my club / team / school / athletic affiliation / facility owner / operator, to release, waive, discharge and covenant not to sue Purler® and the camp and their respective owners, officers, directors, employees, staff, volunteers and agents (the “Releasees”) from any and all liability, claims, demands, actions and causes of action whatsoever arising out of or related to any loss, damage or injury, including death (each, a “Loss”), that may be sustained by me or the athlete or to any property belonging to any of us, while participating in camp activities or while at the Purler® facilities or the camp, REGARDLESS OF WHETHER SUCH LOSS IS CAUSE BY THE NEGLIGENCE OF ANY OF THE RELEASEES or otherwise, and regardless of whether such liability arises in tort, contract, strict liability or otherwise, to the fullest extent allowed by law. I further agree to exonerate, save, indemnify, and hold harmless the Releasees from any and all Losses of any kind and nature whatsoever which may arise from or in connection with the athletes’ conduct at the camp and his or her participation in any camp activities including, without limitation, personal injury, and any breach of this agreement by me or the athletes. It is my express intent that this agreement shall bind the members of my family and spouse, if any, and my heirs, assigns and personal representatives and shall be deemed as a release, waiver, discharge and covenant not to sue the above-named Releasees. In signing this agreement, I acknowledge and represent that I have read this agreement, understand it and sign it voluntarily as my own free act and deed, I am at least eighteen years of age and fully competent, and I execute this agreement for full, adequate and complete consideration fully intending to be bound by the same. Further, I have reviewed this agreement with my club / team / school / athletic affiliation / facility owner / operator, and he or she or they fully understand and agrees to follow all of the terms of this agreement while attending the camp that I / we are hosting and that Purler® is instructing. I further acknowledge that I am responsible for providing insurance for our camp, and that Purler® is merely providing the instruction for us and holds no responsibility for insuring our camp, staff, facilities, athletes, athlete’s parents / guardians, families, or visitors who attend our camp. All information I have provided to Purler® in the camp application or otherwise is accurate and complete.

PWA Registration Form

Wrestler Information

Wrestler 2 Information

Waiver