2018 – 1000 Islands Summer Duals
Permission, Release, Waiver of Liability, and Indemnity
City: _____________________ State:______ Zip:_________
Date of Birth:__________________
Home Phone: (______) ______________________
Emergency Phone: (______) ______________________
We give our son permission to attend and participate
in the 1000 Islands Summer Duals August 3-5, 2018.
understand that his participation in this event involves risks
and dangers that could result in bodily injury, disability,
paralysis, or death. We hereby release, waive, discharge, and
agree not to sue the Eastern Ontario Wrestling Club and/or its
staff for any bodily injury, disability, paralysis, or death
incurred as a result of participating in this event. I verify
that my son has medical insurance and that a physician has
determined he is able to participate in the 1000 Islands Summer Duals.
I also agree to allow my child to be treated by a certified
trainer, emergency medical technician, or a licensed physician
while attending (if necessary).
Parent / Guardian Signature