MILLIKIN YOUTH OPEN
November 12, 2017
LOCATION INFORMATION (CONTACT)
Millikin University Griswold Center Ryan Birt
255 N Oakland 217-621-1291 (cell)
Decatur, IL 62522 217-424-5027 (office)
FOOD ADMISSION
The Millikin Wrestling Team will be Adults: $5.00
serving food all day. It will start Students $3.00
at 7:30 a.m. (6 and under FREE)
AWARDS
We will award first, second, third, and fourth place in each weight class.
ENTRY FEE
Non-refundable $20 per contestant. Pre register by November 8, 2017 by email @ or mail to
Ryan Birt Millikin Wrestling 1184 W Main St. Decatur, Il 62522
OR
Walk in registration 6:45 am – 8:30 a.m. November 12, 2017 in the Griswold Lobby.
Checks payable to Millikin Wrestling.
WEIGH-IN
6:45 a.m. - 8:30 a.m., Sunday, November 12, 2017
Tournament starts at 9:15 a.m.
DIVISIONS
I Pre K & K (1-1-1) II 1st & 2nd grades (1-1-1) III 3rd & 4th grades (1-1-1)
IV 5th & 6th grades V 7th & 8th grades
VI Girl”s 3-5 grades (1-1-1) VII Girl’s 6-8 grades IV, V & VII(1:30-1:30-1:30)
WEIGHT CLASSES
All weight classes will be determined after weigh-in. We will wrestle four or eight man brackets in divisions IV, V and VII if needed. Divisions I, II, III and VIwill all be four man brackets.
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EACH WRESTLER MUST PROVIDE USA CARD AND SIGN THE WAIVER
NAME______AGE______TOWN______
TEAM______PHONE______
USA Card #______
Check One:
( ) Pre K & K ( ) 1st & 2nd grades ( ) 3rd & 4th grades ( )5th & 6th grades
( ) 7th & 8th grades ( ) Girls 3rd-5th grade ( ) Girls 6th-8th grade
WAIVER AND RELEASE OF ALL CLAIMS
Millikin Wrestling Youth Open @ Millikin University
Due to the difficulty and high cost of obtaining liability insurance, the agency providing liability coverage for Millikin Wrestling Youth Open and Millikin University REQUIRES the execution of the following Waiver and Release. Your cooperation is greatly appreciated.
Please read this form carefully and be aware that in registering your minor child/ward for participation in the Millikin Wrestling Youth Open on Sunday November 12th 2017 you will be waiving and releasing all claims for injuries your child/ward might sustain arising out of this program.
I understand that Millikin Wrestling Youth Open and Millikin University does not carry insurance for injuries sustained by participants in this event. Therefore, participants in this event should look to their own health insurance policy for any injuries sustained in connection with or arising out of this event. The absence of health insurance coverage does not make Millikin University responsible for payment of medical expenses.
As a participant in the Millikin Wrestling Youth Open at Millikin University on Sunday November 12th 2017, I agree to assume the full risk of any injuries, including death, damages or loss regardless of severity, which my child/ward may sustain as a result of participating in any and all activities connected with or associated with, or arising out of this event.
I agree to waive and relinquish all claims my child/ward may have as a result of participating in the Millikin Wrestling Youth Open against Millikin University and its directors, officers, trustees, agents, servants and employees. I do hereby fully release and discharge Millikin Wrestling Camp and Millikin University and its directors, officers, trustees, agents, servants and employees from any and all claims from injuries, including death, damage or loss which my child/ward may have on account of their participation.
I further agree to indemnify and hold harmless and defend Millikin Wrestling Youth Open and Millikin University and its directors, officers, trustees, agents, servants and employees from any and all claims from injuries, including death, damages and losses sustained by my child/ward or arising out of, connected with, or in any way associated with the activities of this event.
PERMISSION TO SECURE TREATMENT
In the event of an emergency I authorize Millikin Wrestling Youth Open and Millikin University to secure treatment from any licensed hospital, physician, and/or medical personnel any treatment deemed necessary for my child's/ward's immediate care and I agree that I will be responsible for payment of any and all medical services required.
I have read and fully understand the aforementioned Program Details, Waiver and Release of All Claims and Permission to Secure Treatment, and all information supplied by me is accurate and current to the best of my knowledge.
(Please Print)
Participants Name: ______
Address: ______
Parent/Guardian Signature: ______Date: ______
Relationship to participant: ______
Please contact Ryan Birt with any questions at or 217-621-1291 Cell/ 217-424-5027 Office.
Local Hotels
Decatur Conference Center & Hotel (4 miles from Campus)
Route 36 & Wyckles Rd
Decatur, IL 62522
217.422.8800
Homewood Suites (7 miles from Campus)
333 W. Marion Ave
Forsyth, IL 62535
217.877.0887
Holiday Inn Express (7 miles from campus)
5170 N. Wingate Dr
Decatur, IL 62526
217.875.5500
Country Inn & Suites (7 miles from campus)
5150 Hickory Pt Frontage Rd
Decatur, IL 62526
217.872.2402
Ramada Limited (7 miles from campus)
355 E Hickory Point Rd
Decatur, IL 62526
217.876.8011
Hampton Inn (7 miles from campus)
1429 Hickory Point Dr
Forsyth, IL 62535
217.877.5577
Fairfield Inn (7miles from campus)
1417 Hickory Point Dr
Forsyth, IL 62535
217.875.3337
Comfort Inn (7 miles from campus)
134 Barnett Ave
Forsyth, IL 62535
217.875.1166