City ________________________ State___________ Zip ________________Phone #__________________ Emergency # _________________________Email____________________
Adult Size: S M L XL XXL Graduation Year ____________________
Insurance Co. and Policy# __________________________________
I, the undersigned, give permission for the above mentioned camper to participate in the Golden Pride Wrestling Camps. I hereby release Josh Moore, the Golden Pride Wrestling Staff, and all sponsoring bodies from all liabilities, claims, and damages whatsoever on account of any injury or accident involving the said camper arising out of attendance in the Golden Pride Wrestling Camps or in the course of activities in connection with the Golden Pride Wrestling.