WARNING: No Refunds or Backouts!

Due to the uniqueness of this program, there are no refunds at any time! Be 100% sure you are ready for this commitment, because there is no going back, and no quitting the program early (I richly reward those who can make a commitment and can stand by it.)

Your subscription will run from September 1 2019 – August 31, 2020. Be absolutely certain you are ready to make this commitment before you sign up.

Welcome to the next step in this unique Attack System Silver Journey. Be sure to read through this entire form carefully. I want you to be absolutely certain this is for you, because space is strictly limited.

If you have any questions whatsoever, do not hesitate to contact me prior to making your commitment. I will be glad to answer any questions you may have.

**Warning: Submitting this form serves as an acceptance of the conditions laid out in the program. Be sure to read each part carefully.

Attack System Silver Entry Form

First Name (Athlete) *

Last Name (Athlete): *

E-mail Address: *

Select your Silver Membership *

Street Address: *

Address Line 2:

City: *

State: *

Zip *

School *

Phone Number: *

Graduation Year (LAST 2 digits) *

Date of Birth (MM/DD/YYYY) * / /

Weight as of signup *

Years of wrestling experience *

Accomplishments *

For the health safety and well-being of myself, as well as other wrestlers, I agree to abide by all aspects of the Attack System Health protocols for every program. *

I agree to hold harmless Randy Simpson, staff, property owners and coaches, from and against any injuries sustained by the participant. The understanding hereby releases, waives, and forever discharges Randy Simpson and Randy’s Attack System Wrestling, LLC, from and against any and all claims, injuries, demands, actions, or cause of actions arising out of the participation by the athlete in Randy’s Attack System programs. I authorize the coach and/or staff to act in my behalf regarding any situation requiring discipline or medical attention. My son is physically fit to participate in this program, according to his family doctor. I agree to all conditions of the Attack System Gold Program. *

Video release: I hereby grant permission to Randy’s Attack System Wrestling, LLC, the rights of my child’s image, in video or still, and of the likeness and sound of their voice as recorded on audio or video without payment or any other consideration. I understand that my child’s image may be edited, copies, exhibited, published or distributed and waive the right to inspect or approve the finished product wherein my child’s likeness appears. Additionally, I waive any right to royalties or other compensation arising or related to the use of my child’s image or recording. I also understand that this material may be used in diverse educational settings within an unrestricted geographic area.

No Refunds or Backouts! I understand that my deposit is non-refundable, due to the commitment level and exclusivity of this program, and the limited spots available. I also understand that I cannot back out of my agreement later or end my subscription early. If I do so I will still be responsible for the balance of my commitment.

Submitting this form constitutes a legal agreement to abide by all conditions mentioned in it. Name of Parent/Guardian agreeing to the above commitment: *

I also understand that I have the option of having my payment plan start the first week of September, or I can pay the balance by the beginning of September.

* Required