GIRL COMPETITION HAMMER CAMPS REGISTRATION

CHC Wrestlers Option

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Consent*

I agree to the COVID-19 Risk, Release and Waiver of Claims Form

Assumption of Risk, Release and Waiver of Claims,

I understand that the nation is in the midst of the COVID-19 pandemic, which presents certain unusual health risks that are highly publicized, including fatal illness. I voluntarily chose to participate in a wrestling academy/clinic/camp sponsored and organized by Purler. In consideration for my participation therein, I, on behalf of myself, my personal representatives, heirs, and assigns, hereby:

1. Acknowledge, understand, and agree that there are certain inherent risks and dangers associated with my participation in wrestling and Purler Wrestling Camp, including but not limited to the risk of contracting COVID-19, I knowingly and voluntarily accept and assume full responsibility for each of these risks and dangers, as well as all other risks and dangers that could arise out of or occur during my participation in or association with Purler.

2. Acknowledge, understand, and agree that at all times that I am participating at Purler I will use my best efforts to comply with any and all instructions provided by Purler with respect to maintaining my health and safety, including following CDC Guidelines (e.g., washing hands often, use of hand sanitizer, proper social distancing where possible, wearing appropriate personal protective equipment, covering mouth when coughing or sneezing, and staying home if not feeling well).

3. Acknowledge that, in the event a wrestler, including the undersigned wrestler, must leave due to illness, including COVID-19, that the remaining wrestlers, including the undersigned wrestler may continue to participate at Purler at their own risk. Further acknowledge that Purler cannot, and will not, cease its business activities including Purler Wrestling Camps, each time a wrestler appears to be ill.

4. Acknowledge that Purler is not a healthcare provider and diagnose or treat illnesses. Consequently, Purler will not diagnose or treat illnesses at their Camps/Clinics/Academy.

5. RELEASE, WAIVE, AND FOREVER DISCHARGE Purler (and its respective owners, members, agents, employees, servants, officers, directors, successors, assigns and affiliates) (“Releasees”) from any and all claims, demands, actions, or causes of action I, or anyone on my behalf, may hereafter have against Releasees for loss or damage of any kind (including personal injury, illness, disability, and/or death) which occurs because I contracted COVID-19 while participating with or around Purler, or any of the events and activities associated therewith, whether caused by Releasees’ own negligence or otherwise.

I expressly agree that this Assumption of Risk, Release and Waiver of Claims is intended to be as broad and inclusive as is permitted by the law of the State of Missouri or any other state’s laws under which this Agreement may be construed and that if any portion of this Agreement is held to be invalid, it is agreed that the balance shall, notwithstanding, continue in full legal force and effect.

I HAVE READ, UNDERSTAND, AND VOLUNTARILY AGREE TO THIS ASSUMPTION OF RISK, RELEASE AND WAIVER OF CLAIMS ON THE DATE INDICATED BELOW. I AGREE THAT BY CLICKING THE BOX I AM GIVING MY CONSENT IN ELECTRONIC FORM.

Submission of payment to PWA indicates acceptance of the above terms of the waiver release.

All Competition Hammer Camps and Friday Night Fights are held at our Combative Sports Athletic Center at 4880 Mette Rd in Moscow Mills, MO.

Which Camp Date Are You Selecting?*

Wrestler's Name*

First Last

Wrestler's current height*

Wrestler's current weight*

Wrestler Male/Female*

Male

Female

This is a GIRL camp, Please register for a BOY camp

Wrestler's current age*

Wrestler's Significant Wrestling Accomplishments*

Parent(s)/Guardian(s) Name(s)

First Last

Email*

Address*

Street Address City State ZIP Code

Phone*

Emergency Phone*

Athlete's Cell Phone (If Athlete is Flying in to Camp)

Insurance Company

Policy #

Type Your Name to Accept the Waiver*

By typing your name, you acknowledge and agree that you are over 18 years of age and that your son/daughter has been examined by a physician in the last year and is in good health. I hereby authorize the Purler Wrestling, Inc. Camp Staff to act for me, according to it's best judgment in any medical emergency, and I hereby waive and release the Purler Wrestling, Inc staff from any liability for injuries or illness incurred by my son/daughter while attending camp. All information I have provided on this application is accurate.

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For current PWA & PWA Elite Members, please type the appropriate discount code. All coupons are checked against our rolls.

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Purler Wrestling Competition Hammer Camps Registration

ALL COMPETITION HAMMER CAMPS AND FRIDAY NIGHT FIGHTS ARE HELD AT OUR COMBATIVE SPORTS ATHLETIC CENTER AT 4880 METTE RD IN MOSCOW MILLS, MO

It is very common for our staff to step in and drill / spar / go live with the wrestlers. Obviously we are not there to win or go hard, but to help your wrestlers. If anyone would rather their wrestler (Purler Camper) not train with our coaches, you are expected to OPT OUT by sending and email to us and giving us your wrestler’s name(s) as well as the camp(s) they are attending. [email protected]

Partnering up at Purler Wrestling Camps / Academy, etc: We always ask the wrestlers to partner up at all of our training events, so that they can train with any and all amazing partners we have. It is your child’s responsibility to choose partners close to their age and wt class.

GIRL COMPETITION HAMMER CAMPS REGISTRATION

All Competition Hammer Camps and Friday Night Fights are held at our Combative Sports Athletic Center at 4880 Mette Rd in Moscow Mills, MO.

Purler Wrestling Competition Hammer Camps Registration

ALL COMPETITION HAMMER CAMPS AND FRIDAY NIGHT FIGHTS ARE HELD AT OUR COMBATIVE SPORTS ATHLETIC CENTER AT 4880 METTE RD IN MOSCOW MILLS, MO

Partnering up at Purler Wrestling Camps / Academy, etc: We always ask the wrestlers to partner up at all of our training events, so that they can train with any and all amazing partners we have. It is your child’s responsibility to choose partners close to their age and wt class.

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