This form is MANDATORY and MUST be filled out completely with a Parent/Guardian signature. Your athlete must bring this form with them on their first day of camp in order to participate in the event.

1. ALL AMERICAN-SAVE WRESTLING CAMP
APPLICATION FORM
PLEASE PRINT LEGIBLY
PERSONAL INFORMATION
___________________________________________ ___ _____________________________________________
FIRST NAME! ! ! ! M.I. LAST NAME
______________________________________________________________________________________________
ADDRESS
____________________________________________________________________ _______ ________________
CITY! ! ! ! ! ! ! ! ! ! STATE! ZIP CODE
__________-__________-__________! ! ! ! __________-__________-__________
HOME PHONE! ! ! ! ! ! ! CELL PHONE
________/________/________! ! ! ________________________________________________
DATE OF BIRTH (MM/DD/YY)!! ! E-MAIL ADDRESS
EMERGENCY CONTACT INFORMATION
_____________________________________________ _____ _________________________________________
FIRST NAME ! ! ! ! ! ! ! M.I.! LAST NAME
_______-_______-_______ _________________________________________________________
CELL PHONE/CONTACT PHONE! RELATIONSHIP TO PERSON REGISTERED ABOVE
______________________________________________________________________________________
HEALTH INSURANCE COMPANY
______________________________________________________________________________________
HEALTH INSURANCE POLICY OR GROUP NUMBER
______________________________________________________________________________________
MEDICAL CONDITIONS (KNOWN ALLERGIES, MEDICATIONS, ETC.)
PAYMENT INFORMATION
EARLY REGISTRATION (before Aug 1st., 2013)
_____$40 Both Days
_____$25 One Day
T-Shirt Size (early registration only)
YOUTH ___L ADULT ___S ___M ___L ___XL ___XXL
LATE REGISTRATION (Day of Camp)
t-shirt may be available for purchase
(not guaranteed size)
PLEASE BRING
THIS COMPLETED
FORM TO CAMP ON
AUGUST 2ND AT
8:00 am
AWARENESS OF RISK
By participating in athletic activities there are possibilities of serious injuries and death. The staff working with the All American-Save Wrestling Camp are well qualified professional people.
Safety will be the number one concern. It will continually be emphasized on and off the activity areas. The information contained below is to inform individuals in this program and their
parents of proper techniques for maximum safety.
RULES AND PROCEDURES
1. Always follow prescribed warm up to prevent injuries.
2. Always follow technique outlined by coaches. Do not attempt to improvise.
3. If in doubt to any rules or to what you are doing ask your coach/instructor before preceding.
This report does not cover all potential injury possibilities in the camp, but it is an attempt to make the athletes and their parents aware that fundamentals, coaching, and proper use of
equipment are important to their safety and enjoyment at the All American-Save Wrestling Camp.
By signing the line below, I hereby authorize the staff of the All American-Save Wrestling Camp, or employee of Granite Hills High School, the right to consent any medical treatment needed
for myself/my son/daughter. I understand the rules and procedures as explained above and I am aware of the risks involved in athletic participation. I hereby state that I or my son/daughter
have had and passed a physical examination in the past year and that I am or he/she is in good health in which to compete/participate in rigorous camp activities. I also understand the
necessity of using proper techniques while participating in the All American-Save Wrestling Camp. I hereby assume all responsibilities for myself or my son/daughter and in accordance to the
Education Code Section 72640, I hereby hold the State of California, Porterville Unified School District, or anyone else associated with these associations, and/or any other sponsor(s) or
supporters, harmless for all accident, injury, illness, death, or damages occurring by reason of this event conducted on August 2-3, 2013.
______________________________________ _______________________________________________
CAMPER SIGNATURE! ! ! DATE PARENT SIGNATURE (if camper is a minor under the age of 18) DATE
REGISTER ONLINE VIA Paypal AT
http://allamericansavewrestlingcamp.eventbrite.com