August Youth Camp Signup Page

Submit this entry form and secure your spot in August Youth Mini-Camp Now

First Name (Athlete) *

Last Name: *

E-mail Address: *

Check all camps you are attending *

Street Address: *

Address Line 2:

City: *

State: *

Zip *

School *

Phone Number: *

Graduation Year (LAST 2 digits) *

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

Weight *

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 Camp Health protocol *

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 exclusive program, according to his family doctor. I agree to all conditions of the Summer Attack System Camp. I also understand that no refunds are available (other than those on the signup page) *

Injury Policy: We don't offer refunds for folks who just plain don't show up. However, if your athlete cannot attend due to a medical issue, AND you include documentation from a doctor at least 3 weeks prior to the start of camp, a CREDIT may be applied for future training, minus $50 processing fee deducted from payments made. *

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.

Name of Parent/Guardian agreeing to the above *

* Required