Rhode Island College Wrestling Takedown School & Round Robin for Individuals
Register for our Rhode Island College Takedown School November 10, 2018 by filling out this google form. Parents names serve as a digital signature for the waiver of liability and consent to treat.  
Cost is $25 per individual athlete (2 or more $20 each) by November 8 ($35 if registered after November 8 or at the door).
Arrive at the Rhode Island College Recreation and Events Center for 8:00 check in time.  The youth/middle school takedown school will begin at 8:30am and run through 11:30am.   High School Prospect Session will run 12:30-3:30, check in at noon.
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Last Name (all caps) *
First  Name (all caps) *
Address (please use appropriate capital letters, etc) *
Address 2
Apt. #, Condo #, etc.
City  (please use all capital letters) *
State *
2 letter abbreviation in caps
Zip Code *
Cell Phone *
401-555-5555
Student athlete email (required only if in 9th grade or above)
Parent/guardian Name *
Emergency Number *
Ex. Use dashes - Parent cell phone 401-555-5555
Parent email *
Age of athlete *
Grade of athlete for 2018-19 *
Please just put the appropriate grade number 12,11,10, 9, 8, 7, 6, 5, 4, 3, 2
Session *
School *
Parents must provide their full name and acknowledge this serves as an electronic signature.  ASSUMPTION OF RISK, LIABILITY, AND COVENANT NOT TO SUE.  This is a legally binding contract made between myself, and Rhode Island College and the Rhode Island Board of Governors for Higher Education. I fully recognize that there are dangers and risks to which my child may be exposed to by participating in the 2018 RIC Wrestling Takedown School. I understand that Rhode Island College is permitting my child to do this as a favor to me and my family and my child is under no obligation to participate in this activity, but I want he/she to do so, despite the possible dangers and risks and despite my agreeing to this contract. I agree to assume and take on myself all of the risks and responsibilities in any way associated with this activity. In consideration of and return for the services, facilities, and other assistance provided to me by the Rhode Island College and the Rhode Island Board of Governors for Higher Education in this activity, I release the Rhode Island College and the Rhode Island Board of Governors for Higher Education, its employees and agents from any and all liability, claims and actions that may arise from injury or harm to my child, from his/her death or from damage to my property in connection with this activity. I understand that this contract covers liability, claims and actions caused entirely or in part by any acts or failures to act by the Rhode Island College and the Rhode Island Board of Governors for Higher Education, its employees or agents, including but not limited to negligence, mistake, or failure to supervise by the Rhode Island College and the Rhode Island Board of Governors for Higher Education. I recognize that this contract means I am giving up, among other things, the right to sue the Rhode Island College and the Rhode Island Board of Governors for Higher Education, its employees and agents for injuries, death or any harm to my property. I further recognize and agree that this release is intended by the Rhode Island College and the Rhode Island Board of Governors for Higher Education and me to be subject to the provisions of Rhode Island Gen. Laws § 7-6-9. I have read the above and on behalf of myself and/or my child I agree to its terms and intend that they be legally binding upon me, my spouse, my child, all of our heirs and assigns.    PARENT NAME HERE: *
CONSENT TO TREATMENT OF A MINOR - As parent or legal guardian of athlete, I hereby give my consent for emergency medical care prescribed by a duly licensed Doctor of Medicine or Doctor of Dentistry, or certified medical personnel on staff.  This care may be given under whatever conditions are necessary to preserve life, limb, or the well being of my dependent.  “I understand that the directors, coaches, staff, etc. of Rhode Island College and the Rhode Island Board of Governors for Higher Education will not assume responsibility for accidents or medical or dental expenses incurred as a result of participation in this program.  The applicant is covered by our family insurance, is in good health, and is able to participate in the physical activity of a vigorous program.  I hereby authorize the camp directors and medical staff to act for me accordingly to their best judgment in any emergency requiring medical attention.  I will hold harmless Rhode Island College and the Rhode Island Board of Governors for Higher Education of any and all liability actions causes of action, claims and demands of any kind and nature whatsoever which may arise in connection either with or resulting from participation in any of its activities.”  PARENT NAME FOR CONSENT HERE: *
Insurance Company *
Insurance Policy Number *
PAYMENT - Determine a method of payment below, directions will follow.  After November 8, you must bring payment with you to the event via cash or check - do not bring credit card to the event. *
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