JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
Bethel Allstars Wrestling PCJWL Season Registration
**Please complete one form per wrestler**
Cost per wrestler
First Child: $175
Each Additional Child: $140
Discounts only available for multi wrestlers within individual families in the same household
Cost Includes:
Registration
USA Limited Folkstyle card - required for insurance coverage - purchased by the club
PCJWL League tournament entry fees
*****NEW WRESTLERS***** Must Bring COPY of Wrestlers Birth Certificate turned in First Week of Practice
Sign in to Google
to save your progress.
Learn more
* Indicates required question
Email
*
Your email
*
New Wrestler
Returning Wrestler
USA Card Number - returning wrestlers only
Your answer
Wrestler's First Name
*
Your answer
Wrestler's Last Name
*
Your answer
Address
*
Your answer
City
*
Your answer
Zip Code
*
Your answer
Wrestler's Birth Date
*
MM
/
DD
/
YYYY
Wrestler's School Attending
*
Your answer
Wrestler's Grade
*
Your answer
Wrestler's age as of Jan 1st of current season
(e.g. Season Started Oct 2000, what is the age Jan 1st of 2001)
*
Your answer
Wrestler's Estimated weight in Pounds
*
This is to ensure the club has the correct amount/sizes of singlets.
Your answer
Sex
*
Information for Wrestlers USAWrestlers insurance card
Male
Female
Do you plan to rent or purchase a competition singlet?
*
Singlets will be available to rent for $40 at the beginning of the season. At the end of the season, if the singlet is returned in good condition $20 will be refunded.
Rent
Purchase (or already own a Bethel AllStars singlet)
In order to run a successful season we need volunteers. Please let us know how you would be willing to help
Will provide training and help teach any of these positions
*
Coaching (will require purchase of USAWrestling Leader Card, the club will refund if you coach the whole season)
Interested in helping Bethel Allstars Board (Either becoming a board member or supporting)
Table support at Tournaments (this includes filling out the scorecards or keeping time, would be done in shifts not all day)
Concessions (We will be hosting tournaments and need help running concessions)
Running the Door (We will be hosting tournaments and need help collecting entry fees and directing traffic)
How did you first hear about us?
Returning wrestler
Facebook
website
Existing wrestler
Peachjar
Road signs
Word of mouth
Clear selection
PARENT / GUARDIAN INFORMATION #1
Name
*
Your answer
Phone
*
Your answer
Email
*
Your answer
PARENT / GUARDIAN INFORMATION #2
Name
Your answer
Phone
Your answer
Email
Your answer
EMERGENCY CONTACT ( OTHER THAN PARENT)
Name
*
Your answer
Phone
*
Your answer
Doctor Name
Your answer
Phone
Your answer
Allergies?
*
Your answer
Drug Sensitivities?
*
YES
NO
Describe if yes
Your answer
Is child presently on medication?
YES
NO
Clear selection
List Medication
Your answer
Preferred Hospital
Your answer
Insurance Provider/Group Number
*
Your answer
Next
Page 1 of 5
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google.
Report Abuse
-
Terms of Service
-
Privacy Policy
Forms