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Wrestling Club Liability Waiver -Form Fill

Section One
Q1

Following the pronouncements above I hereby declare the following:
Q2

Name of Guardian (if applicable)

First Name
Q3

Name of Guardian (if applicable)

Last Name
Q4

Name of Athlete

First Name
Q5

Name of Athlete

Last Name
Q6

Phone Number

Phone Number
Q7

Signature
Q8

Date Signed

Date