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All-American Wrestling Camp 2017
Please fill out the following information for your wrestler. Starred (*) fields are required.
Wrestler information
*Wrestler name:
*Gender:
*Wrestler birthdate:
*Grade completed:
*T-shirt size:
*Club name:
Medical information
Please list any medical allergies
Please list any food allergies (Please note Riverview will not be responsible for ensuring food is allergen free)
Is the camper taking any medications? Yes No
If yes, please list all medications.
Is there any other medical information we should know of?
Parent/Guardian information
*Parent/Guardian Name:
*Address:
*City:
*State:
*Zip:
Email:
Home Phone:
Cell Phone:
Work Phone:
Emergency Contact information
The emergency contact needs to be available to pick up the camper at any time, and at their own cost
*Name:
Relation to Camper:
Home Phone:
Cell Phone:
Work Phone:
Release and Arbitration Agreement
I have read and agree to the Release of Liability, and agree to it.
Please note your registration will not be complete until you submit payment.