Register – Stingray Wrestling

STINGRAY WRESTLING
Parent / Guardian Registration

Child's First Name

Child's Last Name

Child's Date of Birth

Child's School

Child's Grade

Child's Address

Child's Shirt Size

Child's Short/Sweatpants Size

Child's Shoe Size

Parent / Guardian First Name

Parent / Guardian Last Name

Parent / Guardian Phone

Parent / Guardian Email

Emergency Contact (if different)

Physician Name

Physician Phone

Allergies / Medications / Medical Conditions

Health Insurance Provider & Policy Number

WAIVER & RELEASE OF LIABILITY: By registering my child with Stingray Wrestling Club, I acknowledge and agree to the following: Assumption of Risk: I understand that wrestling is a physically demanding and contact-intensive sport. I voluntarily assume all risks associated with my child’s participation, including but not limited to injury, illness, or accidents. Release of Liability: I, on behalf of myself, my child, and our heirs, hereby release and hold harmless Stingray Wrestling Club, its coaches, staff, volunteers, sponsors, and facility providers from any and all liability, claims, or demands for injuries, damages, or losses sustained as a result of participation. Medical Authorization: In the event of an emergency, I authorize Stingray Wrestling Club staff to secure necessary medical treatment for my child, and I agree to be financially responsible for any costs incurred. Code of Conduct: I understand that athletes are expected to display sportsmanship, discipline, and respect. Failure to do so may result in dismissal without refund. Consent to Media Use: I grant permission for photos/videos of my child taken during practices or competitions to be used for promotional purposes by Stingray Wrestling Club.

PARENT / GUARDIAN CONSENT: I have read and fully understand this waiver, release of liability, and consent form. I voluntarily agree to its terms.

MEDIA RELEASE CONSENT: I, the undersigned parent/guardian of the above-named athlete, hereby grant permission to Stingray Wrestling Club to use photographs, video recordings, and/or digital images of my child for the following purposes: Promotional materials (flyers, brochures, posters, and banners) Website content and online registration platforms Social media accounts and posts (Facebook, Instagram, Twitter, etc.) Press releases, newsletters, and local media coverage Internal documentation, highlight reels, and training material I understand that: My child’s name will not be published without my prior written consent, unless specifically required (e.g., team roster, tournament brackets). These images and videos may be used indefinitely and without compensation. I may revoke consent at any time in writing, understanding that previously published materials may not be retractable.

YES, I grant permission for my child’s image and likeness to be used for Stingray Wrestling Club marketing and program purposes. NO, I do not grant permission

RELEASE AND WAIVER OF LIABILITY, ASSUMPTION OF RISK, AND IDEMNITY AGREEMENT

I, the minor’s parent/guardian, understand the nature of the Activity and believe the minor is qualified and in proper condition to participate. I hereby release, discharge, and covenant not to sue, and agree to indemnify and hold harmless each Releases from all liability, claims, demands, losses, or damages on the minor’s account, caused in whole or in part by negligence of the Releasees. Child Release: As parent or legal guardian acting on behalf of my child, I hereby release and forever discharge and hold harmless the Town of Babylon and its employees from any and all liability, claims, and demands of whatever kind or nature, either in law or in equity, including any claim for negligence, arising from my child’s participation in this program. By enrolling my child in this program, I fully assume the risk of any illness, injury or harm to my child during or as a result of program activities. I understand that my child can be removed from the program if he or she acts in a disorderly or disruptive manner or fails to follow instructions given by Town personnel. Adult Release: I hereby release and forever discharge and hold harmless the Town of Babylon and its employees from any and all liability, claims, and demands of whatever kind or nature, either in law or in equity, including any claim for negligence, arising from my participation in this program. By enrolling in this program, I fully assume the risk of any illness, injury or harm to me during program activities. I agree to abide by all Town of Babylon policies and procedures and to follow all rules and instructions provided by Town personnel. I understand that my failure to do so may result in my expulsion from the program and/or the loss of the right to enroll in addition Town programs or to use Town facilities in the future.

(18+ Years Old) RELEASE AND WAIVER OF LIABILITY, ASSUMPTION OF RISK, AND IDEMNITY AGREEMENT: IN CONSIDERATION of being permitted to participate in any way in any event (“Activity”) at any time during the current membership year, I, for myself, my personal representatives, assigns, heirs, and next of kin: ACKNOWLEDGE, agree, and represent that I understand the nature of the Activity and that I am qualified, in good health, and in proper physical condition to participate. I further agree that if, at any time, I believe the conditions to be unsafe, I will immediately discontinue participation. FULLY UNDERSTAND that: (a) This Activity involves risks and dangers of serious bodily injury, including permanent disability, paralysis, and death (“Risks”); (b) These Risks and dangers may be caused by my own actions or inactions, the actions or inactions of others, the conditions of the Activity, or negligence of the Releasees; (c) There may be other risks not known or readily foreseeable; I fully accept and assume all risks and responsibility for losses, costs, and damages incurred as a result of participation. HEREBY RELEASE, DISCHARGE, AND COVENANT NOT TO SUE Stingray Wrestling Club, its administrators, directors, agents, officers, members, volunteers, employees, other participants, officials, sponsors, advertisers, owners/lessors of the premises, and rescue personnel (the “Releasees”) from all liability, claims, demands, losses, or damages caused or alleged to be caused, in whole or in part, by negligence of the Releasees. INDEMNITY AGREEMENT: If I or anyone on my behalf makes a claim, I will indemnify and hold harmless each Releasee from litigation expenses, attorney fees, loss, liability, or costs resulting from such claim.

I ACKNOWLEDGE THAT I AM AGE 18 OR OLDER, HAVE READ THIS AGREEMENT, UNDERSTAND ITS TERMS, AND SIGN IT FREELY WITHOUT INDUCEMENT.

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STINGRAY WRESTLINGParent / Guardian Registration

STINGRAY WRESTLING
Parent / Guardian Registration