Waiver Form

Tar Heel Wrestling kid's club liability waiver

* Indicates required field

Wrestler's Name *

First

Last

Weight *

Date of Birth *

USA Wrestling Number *

School *

Wrestling Experience (Years) *

Grade *

Email *

Phone Number *

Home Address *

Line 1

Line 2

City

State

Zip Code

Country

Parent/Guaridan *

First

Last

Cell Number *

Email *

Parent/Guardian *

First

Last

Cell Number *

Email *

Insurance Company *

Policy Number *

Medical Issues, Allergies, Special Care, Etc. *

It is expressly agreed that participation in TAR HEEL KID'S WRESTLING CLUB and all use of the UNIVERSITY OF NORTH CAROLINA and its facilities shall be undertaken by the wrestler and parent/guardian at his or her risk. It is further agreed that TAR HEEL KID'S WRESTLING CLUB and/or the UNIVERSITY OF NORTH CAROLINA shall not be liable for any injuries or damages to the wrestler, parent/guardian, or other children with parent/guardian, nor the subject of any claim, injury, or damages, whatsoever, including but not limited to damages resulting from acts of active or passive negligence on the part of TAR HEEL KID'S WRESTLING CLUB, the UNIVERSITY OF NORTH CAROLINA, its successors or its officers or agents.

It is specifically agreed that TAR HEEL KID'S WRESTLING CLUB and the UNIVERSITY OF NORTH CAROLINA shall not be responsible or liable to the wrestler and/or parent/guardian for articles lost or stolen at the club training facility (UNIVERSITY OF NORTH CAROLINA Wrestling Room – Fetzer Gym). TAR HEEL KID'S WRESTLING CLUB and the UNIVERSITY OF NORTH CAROLINA shall not be responsible or liable for loss or damage to any other property of the wrestler and/or parent/guardian including but not limited to their automobile(s) and contents thereof. It is also agreed that any damages to the program training facility (UNIVERSITY OF NORTH CAROLINA Wrestling Room – Fetzer Gym) or property of any wrestler and/or parent/guardian by any other wrestler and/or parent/guardian, is the sole responsibility of the offending wrestler and/or parent/guardian.

I have identified all medical problems that TAR HEEL KID'S WRESTLING CLUB should be aware of and have provided all special instructions on this Registration Form. I understand that photographic, video and/or other images of my child may be obtained and used in the media, on TAR HEEL KID'S WRESTLING CLUB website, or in other TAR HEEL KID'S WRESTLING CLUB promotional and publicity materials at the discretion of TAR HEEL KID'S WRESTLING CLUB, and that if I do not wish for my child's image to be used for these purposes I must request so in writing.

I expressly agree that this release, waiver and indemnity agreement is intended to be as broad and inclusive as
permitted by the laws of the State of North Carolina. This release is an agreement between the parties. This agreement and the terms of this release are contractual and not a mere recital.

By marking yes you give permission for the above athlete to participate in the TAR HEEL KID'S WRESTLING CLUB and any associated functions. You also certify that you are the managing conservator of this athlete and are authorized to accept the terms of this agreeement.

Authorization and Release of Claims *

I ACCEPT THE TERMS OF THIS AGREEMENT

Submit