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Athlete Name
(Required)
First
Last
Phone Number
(Required)
Age
(Required)
USA Card Number
(Required)
Every wrestler must have a USA Card Number athlete number.
Grade Level
(Required)
Pre-K
K
1st
2nd
3rd
4th
5th
6th
7th
8th
9th
10th
11th
12th
Date of drop-in practice
(Required)
MM slash DD slash YYYY
Estimated Weight Class
(Required)
Please put wrestlers estimated weight so that we can help ensure that everyone has a partner.
Estimated Years of Wrestling Experience
(Required)
Please put wrestlers estimated years of experience so that we can help ensure that everyone has a partner.
Elementary/Highschool
(Required)
Please put the full name of the school that you wrestler attends.
Address
(Required)
Street Address
Address Line 2
City
State
Alabama
Alaska
American Samoa
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Guam
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Northern Mariana Islands
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
U.S. Virgin Islands
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
ZIP Code
Parent Information
Parent Name
(Required)
First
Last
Parent Phone
(Required)
Email
(Required)
Enter Email
Confirm Email
Emergency Contact
Contact Name
(Required)
First
Last
Relationship
(Required)
Emergency Phone
(Required)
Emergency Email
(Required)
Address
(Required)
Street Address
Address Line 2
City
State
Alabama
Alaska
American Samoa
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Guam
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Northern Mariana Islands
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
U.S. Virgin Islands
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
ZIP Code
Payment
How did you hear about WCRTC K-12 Club
(Required)
Drop-in Fee
(Required)
Price:
Payment Address
(Required)
Street Address
Address Line 2
City
State
Alabama
Alaska
American Samoa
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Guam
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Northern Mariana Islands
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
U.S. Virgin Islands
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
ZIP Code
Credit Card
Credit Card
(Required)
Card Details
Cardholder Name
Total
Consent
(Required)
I agree to the privacy policy.
I hereby register my child for the West Coast RTC K-12 Wrestling Club and authorize the club to coach and direct their participation in all club/camp related activities. I understand that my child who is named above will be participating in vigorous physical activities and neither my child or myself will hold West Coast Regional Training Center liable for any injuries or an expense relating to injuries while my child is at any West Coast Regional Training Center Practice, Camp, Private Lesson, and any other event.
I acknowledge that my child is physically able to perform all activities and does not have any Medical Conditions, Allergies, or impairments that the staff was not previously made aware of.
I shall fully comply with all applicable laws, policies, and Club rules and regulations while participating in any and all Club activities. If my child’s participation in any and all Club activities is deemed detrimental to the Club or any of its participants, as determined by West Coast Regional Training Center in their sole discretion, I understand that 1) my child may be expelled from the Club without West Coast Regional Training Center incurring any liability and 2) I may incur liability to West Coast Regional Training Center under this Agreement. 3) I will not receive a refund if my child is expelled from the West Coast Regional Training Center.
I hereby grant and authorizeWest Coast Regional Training Center the right to take, edit, alter, copy, publish, distribute, and to use all pictures and media taken of my child at West Coast Regional Training Center to be used in and promotional or advertisement that they so see fit.
I release, waive, and discharge not to sueWest Coast Regional Training Center and WCRTC Wrestling Club, its coaches, administrators, directors, and any and all employees or representatives, and California Baptist University facilities. All of which are released from any and all demands, losses or damages on account of injury, including death or damage to property, caused or allegedly caused by participation in West Coast Regional Training Center, WCRTC Wrestling Club or any and all West Coast Regional Training Center Camps/Clinic.
I understand that a cancellation of membership will only be processed if emailed in writing to
WestCoastRTC2023@gmail.com asking for a cancellation of membership. I also understand and agree that no refunds will be given when requesting to cancel my membership.
I will follow all posted rules and guidelines of West Coast Regional Training Center during any practices, camps, or events.I have read all the above information and agree to all the terms and conditions.
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Vision
Coaches
DEREK MOORE
ERIC MORRILL
NOAH HARDY
NATHAN TOMASELLO
MARK MUNOZ
JOSE CAMPO
Athletes
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