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PURLER WRESTLING ACADEMY – CORE SKILLS REGISTRATION – MONDAY YOUTH/HS AT WINDSOR IMPERIAL HIGH SCHOOL

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  • By typing your name, you acknowledge and agree to the medical waiver below and that you are over 18 years of age. My 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, illness, or skin infections incurred by my son/daughter while attending camp. I acknowledge that participating in a Purler Wrestling camp involves known and unanticipated risks which could result in physical or emotional injury, paralysis or permanent disability, death, and property damage. Risks include, but are not limited to: broken bones, torn ligaments or other injuries as a result of falls or contact with other participants. I understand such risks simply cannot be eliminated, despite the use of safety equipment, without jeopardizing the essential qualities of the activity. I represent that I have adequate insurance to cover any injury or damage my child may suffer or cause while participating in this activity, or else I agree to bear the costs of such injury or damage myself. I further represent that my child has no medical or physical conditions which could interfere with his/her safety in these activities, or I am willing to assume "and bear the costs of " all risks that may be created, directly or indirectly, by any such condition. All information I have provided on this application is accurate.
  • $0.00

For more than two wrestlers, contact Nick. For insurance purposes, all athletes must have a USA Wrestling card to attend. https://www.usawmembership.com/login

General Waiver Release

I fully understand that the Purler Wrestling, Inc. staff are not physicians or medical practitioners of any kind. With the above in mind, I hereby release the Purler Wrestling, Inc. staff to render temporary first aid to my child or children in the event of any injury or illness, and if deemed necessary by the Purler Wrestling, Inc. staff to call our doctor and to seek medical help, including transportation by a Purler Wrestling, Inc. staff member and / or its representatives, whether paid or volunteer, to any health care facility or hospital, or the calling of an ambulance for said child should the Purler Wrestling, Inc. staff deem this to be necessary.

In consideration of your acceptance of this entry, I intend to be legally bound hereby for myself, my heirs, executors and administrators waive and release PURLER WRESTLING, INC, THEIR AGENTS, REPRESENTATIVES, COACHES, VOLUNTEERS, FROM ANY AND ALL CLAIMS OR RIGHTS TO DAMAGE FOR INJURIES OR LOSSES SUFFERED BY ME DIRECTLY OR INDIRECTLY IN TRAINING OR TRAVELING TO OR FROM OR COMPETING IN, OR ATTENDING the training camp.

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.
  1. 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).
  1. 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.
  1. 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.
  1. 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.

COVID Assumption of Risk, Release and Waiver of Claims,  

I  am a wrestler and participant at Purler Wrestling Inc. operating Academy/Clinics/Camps (“Purler”).  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).  Additionally, I agree to self-quarantine for 14 days upon arrival back home following my Purler camp.
  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 UPON MY ENROLLMENT IN PURLER WRESTLING.

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

Please use a credit card, and avoid using a debit card, if at all possible.  Thank you.

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