West Coast Wrestling Camps

WESTCOAST WRESTLING CAMPS

2009 Registration Application

Applicant’s Name ______Male/Female E-Mail ______

Address______City______State ______Zip ______

Age ______DOB______Phone (_____)______Work Phone (_____)______

School ______Grade Fall 2009______Weight ______

T-Shirt Size: YM YL S M L XL XXL XXXL Roommate Preference ______

Please Check:

Advanced Technique Camp 5-DayIntensive Training Camp Both CampSessions

Carlsbad, CA Carlsbad, CA Carlsbad, CA

August 3-7 August 8-12 August 3-12

Resident-$500 Commuter-$400 Coach-$250 Resident-$500 Commuter-$400 Coach-$250 Resident-$1060 Commuter-$800 Coach-$500

Discounts ($25 off per wrestler): Early Registration(Postmarked by 3/15/2009) Group (10 or more) (Please Note: Only one discount may apply)

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Emergency Contact ______Phone (_____)______Relationship ______

Medical Concerns ______Allergies ______

Insurance Co. ______Policy # ______

I APPROVE my child’s attendance at the West Coast Wrestling Camp and certify that he/she is in good health (medical examination within the year is strongly recommended). If medical attention is required for illness or injury during camp, I hereby grant my permission for West Coast Wrestling Camp officials to act for me according to their best judgment in any medical emergency. West Coast Wrestling Camps, or its affiliates, does not assume any responsibility for medical, dental, or other expenses incurred through the duration of the camp.I recognize that the camp facility and/or camp officials assume no responsibility for any injury of any kind that may occur on the way to, during, or on the way home from any camp session sponsored by West Coast Wrestling Camps.

I UNDERSTAND that all campers must comply with camp rules and regulations set by West Coast Wrestling Camps. Any person(s) who willfully violate or abuse these rules will be subject to immediate expulsion from the camp at their own expense. West Coast Wrestling Camps is not responsible for early departure arrangements. Any arrangements for early departure must be made by the parent or guardian. Any arrangements for early departure made by camp officials will result in a $50 processing fee. I also understand that refunds will not be given for any reason after the start of the first session.

I ACKNOWLEDGE that my son/daughter will not be required at any time to participate in water activities. Water use is for recreation only and should be used at the discretion of the camper.

I AGREE to my child being photographed and/or videotaped for West Coast Wrestling Camps,which will be used solely for promotional purposes.

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Parent or Guardian SignatureDate

Please Send Application and $100 Non-Refundable DepositPayable to:

West Coast Wrestling Camps; 22141 Cosala, Mission Viejo, CA 92691

(Please note that balance is due 2 weeks prior to the start of the camp)