Olympic Regional Training Center Participation

* THERE IS A DEAD PERIOD NOV 11-NOV 14, NO HIGH SCHOOL WRESTLERS ALLOWED AT RTC PRACTICE DURING THIS TIME*

For any wrestler to attend RTC practice you MUST:

1. Meet one of the criteria listed here.

2. Live within 250 miles of State College.

3. Have an updated USA Wrestling Membership.

4. Fill out the form below.

Practice times are the following:

M: 1:30pm

T: 1:30pm

W: OFF

TH: 1:30pm

F: 1:30pm

*Times are subject to change. If you have any questions contact info@nittanylionwrestlingclub.com

Olympic Regional Training Center Participation Form

Section 1: Wrestler Information

Name:*

Home Address:*

Home City:*

Home State:*

Home Zip:*

Cell Phone:*

Email:*

Date of Birth:*

Age:*

Current Grade:*

High School Year of Graduation:*

Current Weight:*

If Wrestler is Under Age 18, Information Listed Below is Required

Parent/Guardian Name:*

Parent/Guardian Cell Phone:*

Parent/Guardian Email:*

Section 2: Criteria to Practice

USAW Wrestling Competitor Card Number:*

Card Expires On: August 31:*

List Competitive Accomplishment(s) that Qualifies you for Olympic Regional Training Center Practices:*

Section 3: Release/disclaimer

I do hereby assume full responsibility for any and all damages, injuries (including death), or losses that I may sustain or incur, if any, while attending, engaging, practicing, participating or witnessing activity and/or certain event(s) occurring in or about the premises or at any offsite location. I hereby assume full risk, waive all claims and release and hold Nittany Lion Wrestling Club Olympic Regional Training Center Practices/Nittany Lion Wrestling Club individually or otherwise, harmless for any and all liability, claims, suits, damages, expenses, fees, actions, or rights of action or judgments as a result of injury or death to myself or members of my family or heirs, or my guests, or damage, destruction or loss to my property, which in any way relates to, arises out of, or is in any way connected with my presence on the premises, or my participation in events of activities thereon, or the negligent acts or omissions of the releases or any other third party.

I agree to wear all protective equipment required while participating in the activity, and I am fully aware and understand that Nittany Lion Wrestling Club Olympic Regional Training Center Practices/Nittany Lion Wrestling Club does not have on or about the premises, or employ or contract with any medical services, provisions for ordinary or emergency medical services.

In consideration of my participation in and the use of the Nittany Lion Wrestling Club Olympic Regional Training Center Practices/Nittany Lion Wrestling Club premises or facilities, I hereby release and covenant not to sue the owner of the premises (releases), shareholders, directors, officers, employees, representatives, agents, affiliates and lessees from any and all claims resulting from any physical injury that may occur to me while participating in any program or event sponsored by Nittany Lion Wrestling Club Olympic Regional Training Center Practices/Nittany Lion Wrestling Club.

I HAVE READ AND FULLY UNDERSTAND THE ABOVE RELEASE/WAIVER AND FULLY UNDERSTAND THAT I HAVE GIVEN UP SUBSTANTIAL RIGHTS BY SIGNING THIS WAIVER VOLUNTARILY.

Parents or guardians must sign if applicant is UNDER 18.

Participant Signature:*

Date:

Parent/Guardian Signature:

Date:

Confirm Website ID (don 't touch):Website ID:

Cancel

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