2023-2024 LDYW Club Registration

Welcome to the Lower Dauphin Youth Wrestling Club's Registration Form! 

To complete the registration process, this form requires accurate personal information, agreement with waivers and codes of conduct, and full payment of the fee via PayPal (only). 

The LDYW Club is excited to offer a season of wrestling for boys and girls of all levels of experience. Our nonprofit 501(c)(3) organization serves LDSD students in Kindergarten through 6th grade. All Board members, coaches, and managers are volunteers. Sponsorships are tax-deductible. 

Non-LDSD wrestlers may participate in this wrestling club per league rules (e.g., may practice with us, but will not participate in league events). The LDYW Club will provide: weekly practices, various optional competitions, spirit packs, and developmentally appropriate opportunities to grow wrestling knowledge, skills, and Falcon P.R.I.D.E. 

Our core values are: character, sportsmanship, and love to wrestle. 

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Our LD K-12 Wrestling program has a "KICKOFF DINNER & MEETING" on Wednesday November 8 @ 5pm in the LDHS cafeteria. It is a potluck dinner and important event that unites the youth and high school programs. 

Join us! 

Please RSVP HERE (NOW)

Please SIGN UP HERE (NOW) to donate something to share. 

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Our FIRST practice is November 9, specifically: 

       Beginners 6-7pm in the LD Falcon Field House

       Intermediate and Advanced will combine from 6-7:30pm in the LDHS Wrestling Room

The REMAINING practices, beginning the following week, are as follows: 

Beginners (Kindergarteners and first-year 1st graders) will practice practice Tuesdays/Thursdays at the LD Falcon Field House (next to turf fields on LDMS campus) from 6-7pm. Kindergarteners are not encouraged to participate in tournaments and will not be permitted to participate in CPWA ("league") events.

Intermediate (second-year 1st graders to 4th graders) will practice Monday/Wednesday at the LD Falcon Field House (next to the turf fields on the LDMS campus) from 6-7:30pm. 

Advanced (previous dual/competition team members and all 5th and 6th graders) will practice Monday/Tuesday/Wednesday in the LDHS Wrestling Room from 6-7:30pm. Enter Door #18, near the white gazebo. 

LDYW Board and Coaches will make the best decisions on group placement, which is fluid. 

Our practices are closed to spectating parents/guardians; this means only LDYW organization members are permitted in the room during practices.  

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Registration closes November 27, 2023.

If you have questions or concerns about this form, please explore www.LDyouthWrestling.com. If you still have questions and concerns, please email LowerDauphinYouthWrestling@gmail.com. 

Thank you for your interest and support.

GO FALCONS!

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Email *
LAST name of wrestler: *
FIRST name of wrestler: *
Wrestler's birthdate: *
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What is the wrestler's current age? *
Which school does the wrestler attend?  *
If your wrestlers does not attend a school in LDSD, what SCHOOL and SCHOOL DISTRICT does your wrestler attend? 

If your wrestler doesn't attend any school, leave this question blank. 
What grade is the wrestler in?  *
Does the wrestler reside in the Lower Dauphin School District?  *
Does this wrestler have any family members who will also be registering? If so, please indicate the first and last name(s) below. This registration page/system only permits one registrant at a time. You must separately register each participant on their own form. *
Full name of first parent/guardian?  *
Full name of second parent/guardian?  *
Parent/guardian email address? This will be the email LDYW uses to communicate with you. If you want to add a second or third email address, please separate them with a semicolon.  *
Each wrestler will receive and keep a free LDYW spirit pack (t-shirt and shorts). These are to be used by wrestlers to warm up before a match or wear to practices. 

What is the wrestler's t-shirt size? 
 *
What is the wrestler's short size?  *
Approximate weight of the wrestler?  *
#1 Emergency contact information (MUST INCLUDE: full name, relation, and phone number) *
#2 Emergency contact information (MUST INCLUDE: name, relation, and phone number) *
Wrestler's home mailing address? 

FORMAT: 
family name,
number, 
street name, 
municipality, 
zip code
 *
Gender of wrestler?  *
Novice (new wrestler with 0-2 years of experience) or Open (advanced, 2+ years of experience)?  *
Interested in advanced/competition level wrestling?  *
Does the wrestler have any allergies, medical or other conditions that LDYW needs to be aware of and provide accommodations for? If so, please list below.
 *
Health insurance provider? Preferred physician? Physician's phone number?  *
WRESTLING SINGLET WAIVER

LDYW provides wrestling singlets that are worn during matches in duals, quads, and tournaments. They are expensive and must be returned promptly after the season ends in late January. If they are not returned, as expected and requested, your family is liable for the fee of $100 to replace the singlet. 

I/We have read, understand, and agree return singlets as explained above.
 *
WAIVER OF LIABILITY / CONSENT TO PARTICIPATE

I understand wrestling and its related activities are dangerous and that I or my child could be seriously injured while participating. Injuries that could occur include but are not limited to: paralysis, brain injury, sprains and broken bones. I understand that if my child is participating in a youth sports program that he/she will be coached by volunteer coaches who will not be full-time or professionally trained. Recognizing the inherent risks associated with participating in the above noted program and still desiring myself or my child to participate, I hereby agree to indemnify and hold harmless the Lower Dauphin Youth Wrestling Club, Lower Dauphin School District, and the members, employees, volunteers and all individuals responsible for the conduct of activities involving myself or my child(ren) for claims including, but not limited to claims of personal injury, hospitalization, property damage, etc. I also understand that the LDYW Club strongly recommends that each participant have medical approval before participating in any sport, and that I must inform the LDYW Club of any medical condition that may require special attention or treatment. I do fully understand that a physical examination is not required in this program, but is strongly recommended. We also understand that this wrestling activity is a full-contact sport. 

If we or our emergency contact are unable to be contacted, we give our consent to medical/surgical treatment as necessary. I or my child(ren) are participating under our own free will, and we will not in any way hold the Lower Dauphin Youth Wrestling (LDYW) Club, its coaches, or Lower Dauphin School District, volunteers, employees or agents thereof liable for any and all injuries that we (wrestler or family) may receive, or in any and all losses that we may incur directly or indirectly, from training for, traveling to or from, or participating in the aforementioned wrestling program or related activities. I warrant that my child(ren) or I are privately insured with a medical insurance policy.

I/We have read, understand, and agree to comply with the waiver as outlined above. 

 *

MEDIA RELEASE AND AUTHORIZATION WAIVER

I hereby grant the Lower Dauphin Youth Wrestling (LDYW) Club permission to use my child's likeness in video or photographs in any and all of its publications, including web-based, social media, or printed entries and articles, without payment or any other consideration. I understand and agree that these materials will become the property of the Lower Dauphin Youth Wrestling (LDYW) Club and will not be returned unless specially requested. I hereby irrevocably authorize the Lower Dauphin Youth Wrestling (LDYW) Club to edit, alter, copy, exhibit, publish, or distribute these photographs for the sole purposes of publicizing the wrestling program or for any other lawful purpose. I waive the right to inspect or approve the finished product, including written or electronic copy, wherein the likeness appears. I waive the right to royalties or other compensation arising or related to the use of the photograph. I hereby hold harmless and release and forever discharge the LDYW Club and Lower Dauphin School District from any and all claims, demands, and causes of action which I, my heirs, representatives, executors, administrators, or any other persons acting on my behalf or on behalf of my estate have or may have by reason of this authorization. 

I/We have read, understand, and agree to comply with the waiver as outlined above. 

 *

CENTRAL PENNSYLVANIA WRESTLING ASSOCIATION (CPWA / OUR "LEAGUE") 

CODE OF CONDUCT

We are looking forward to another exceptional year of youth wrestling.  Every coach, wrestler, parent, and spectator are not only a representative of the Central Pennsylvania Wrestling Association (CPWA) and their respective Club, but of our community. Our actions are as important as our words, so please lead by example to show our children the true definition of “good sportsmanship.”

By completing this registration, you agree to comply with the CPWA Parent and Spectator Code of Conduct, and requiring that your wrestler complies with the Wrestlers Code of Conduct. 

WRESTLERS CODE OF CONDUCT:
1. No wrestler is to physically or verbally abuse any coach, official, or fellow wrestler.

2. Wrestlers must listen to and follow the directions of all coaches and officials. Wrestlers are not to be disruptive during competitions.

3. At all times, wrestlers must conduct themselves in a sportsmanlike manner.  For example, wrestlers should shake hands with their opponent and his or her coach following every match, win or lose.

4. Unsportsmanlike yelling or cheering if a wrestler is hurt is prohibited.

5. No vulgar or obscene gestures of any kind should ever be made by a wrestler.

6. No wrestler is to use abusive and/or profane language before anyone connected with a CPWA event.

7. Wrestlers must comply with these bylaws at all times, including the uniform requirements.

PARENTS AND SPECTATOR CODE OF CONDUCT:

1. No parent or spectator shall physically or verbally abuse another parent, spectator, coach, wrestler or referee. If a parent has a problem, concern or issue with a spectator, wrestler or another parent, the only proper venue for discussion is with a CPWA staff member in private at an appropriate time.

2. All parents are to conduct themselves in a sportsmanlike manner.

3. No unsportsmanlike yelling, such as: booing, teasing, or cheering if a wrestler is hurt or losing. No instructions to take specific advantage of any injury incurred by an opponent while wrestling.

4. No unsportsmanlike gestures of any kind will be allowed.

5. Except in an emergency, no parent is to interfere with duals or coaching at any time. 

6. Parents are NOT permitted to coach their child (on the edge of the mat) at any official competition of the CPWA unless you are an approved member of the coaching staff. Parents should remain in designated spectator locations during official practices and events.

7. Parents and spectators must act in accordance with the rules of the host facility, and may not damage any property or equipment of the host Club.

Parents, Coaches, Clubs, as well as their athletes, will be held responsible for compliance with the Code of Conduct. Violation of the Code of Conduct will result in disciplinary action, up to and including expulsion from the CPWA.  The CPWA shall also apply PIAA conduct and sportsmanship rules.  A disqualification at a league event shall result in immediate suspension from the next event.

I/We have read, understand, and agree to comply with the waiver as outlined above. 

 *

LDYW (ACADEMIC/DISCIPLINE) CODE OF CONDUCT

Wrestlers are expected to be student-athletes who make good, healthy decisions. The wrestler's focus should be on academics and character. If your wrestler is absent from school due to health (sick) issues or school discipline issues, he or she is not permitted to attend LDYW events. This expectation is in line with LDSD policies and procedures. 

I/We have read, understand, and agree to comply with the waiver as outlined above. 

 *
As a nonprofit 501(c)(3), volunteer based organization, we rely on parents/guardians to make our program a success. If you want to get involved or learn more about getting involved, please indicate your preference. 
Fee (only PayPal is accepted): 

Kindergartener: $75

1st grade to 6th grade: $105

Sibling: $55. You must separately register each participant on their own form.

We ONLY accept PayPal. Be sure to indicate your wrestler's name in PayPal. 

If you would like to sponsor another wrestler or donate money to offset the cost for another wrestler, please indicate that during registration and/or contact us via email.

Go to PayPal (PayPal.Me/LDYWclub), click "send," log in, and then type your wrestler's full name in the box entitled "What is this for?" 
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Questions, comments, or concerns? 

Please visit www.LDyouthWrestling.com, contact LowerDauphinYouthWrestling@gmail.com, and/or enter them below.
After your registration is complete, your email account will receive an email confirmation with a copy of all of the information you submitted. Retain it.

Do you understand and agree to READ and RETAIN that confirmation email?
 *
A copy of your responses will be emailed to the address you provided.
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