Registration

Grande Prairie Wrestling Club

Club Policies

Please read the club policies before filling out the online form below

or on the Policies page.

Anti-Bullying Policy

Medical Release Form

Photo & Media Release Form

Athlete Code of Conduct

Registration Form:

You'll be asked for:
The Athlete's Alberta Healthcare number
Signatures from a Parent
Signatures from the Athlete

GPWC Registration

I want to subscribe to the newsletter.

School Attending:

Wrestler first name:

Wrestler last name:

Gender: M, F, Other please specify:

Thanks for submitting!

Address:

Age:

Birthday:

Alberta Healthcare #

Approximate Weight in Kg or Lbs:

Mother's Name:

Mother's Phone #

Father's Name:

Father's Phone #

Emergency Contact Name & Phone Number:

Parent Email

Wrestler Email

How many years have you wrestled?

What other sports have you participated in?

GPWC Wrestler Medical History & Medical Release

If answered other, please specify

List any allergies, if any:

Have there ever been any injuries to any part of the body? Please list what injuries and dates:

If yes, why:

Do you wear contact lenses?

Yes

Do you have dental appliances?

Yes

Do you have any chronic conditions that have not been mentioned above?

Yes

If yes, please list them:

Wrestling is a reasonably safe sport as long as specific guidelines are followed. Wrestling is a contact sport and injuries to the neck, shoulders, arms, back, and other injuries related to a contact sport may result. If you have any physical
condition that precludes you from such activities, please obtain a physician’s consent to participate.

The questions on this form have been answered completely and truthfully to the best of my knowledge. I have read the
proceedings and certify that I am physically fit for the sport of wrestling. I fully understand the risks inherent in the sport of
wrestling.

I voluntarily participate in this activity.

Wrestler's Name:

Parent's Signature

Select a date

Medical Release

Representatives of the Board of Directors and/or Coaching Staff have my permission to secure medical attention,
hospitalization, ambulance transportation etc. for our child:

while attending practice, traveling to and from scheduled meets, and during wrestling meets.

Our child is allergic to these substances:

Other conditions that influence the medial treatment of my child:

Family Physician & Phone#

Wrestler's Name:

Select a date

Parent's Signature

I do not consent to medical treatment and hereby release the above representatives from ALL responsibilities.

Parent's Signature

Select a date

Anti-Bullying Policy Acknowledgement Form

hereby acknowledge that I have read and fully understood the Anti-Bullying Pamphlet provided by the Grande Prairie Wrestling Club Board of Members and I fully
understand BULLYING of any kind is unacceptable in our club.

I also understand what could happen if I
am caught and or participating in any kind of this behavior and its repercussions of such acts if they were to occur.

Yours truly. (GPWC Board members)

Signature of Athlete

Athlete's Name:

Parental Signature (if participant under 18)

Photograph & Video Release Form

I hereby grant permission to The Grande Prairie Wrestling Club the rights to my child’s/children’s image, likeness, and
sound of their voice as recorded on audio or video tape without payment or any other consideration. I understand that
their image may be edited, copied, exhibited, published, or distributed, and waive the right to inspect or approve the
finished product wherein my likeness appears. Additionally, I waive any right to royalties or other compensation
arising or related to the use of my image or recording. I also understand that this material may be used in diverse
educational settings within an unrestricted geographic area.

Photographic, audio or video recordings may be used for the following purposes:
● conference presentations
● educational presentations or courses
● informational presentations
● on-line educational courses
● educational videos
● promotional marketing
● Grande Prairie Wrestling Club's social media

By signing this release I understand this permission signifies that photographic or video recordings of my
child/children may be electronically displayed via the Internet or in the public educational setting.
I will be consulted about the use of the photographs or video recording for any purpose other than those listed above.
There is no time limit on the validity of this release nor is there any geographic limitation on where these materials
may be distributed.
This release applies to photographic, audio or video recordings collected as part of the sessions listed on this document only.

By signing this form I acknowledge that I have completely read and fully understand the above release and agree to be
bound thereby. I hereby release any and all claims against any person or organization utilizing this material for
educational purposes.

Athlete Signature

Parent's Signature

If this release is obtained from a presenter under the age of 18, then the signature of that presenter's parent of legal guardian is also required.

Select a date

Thanks for submitting!