Burrell Youth Wrestling 2014-15 REGISTRATION
Burrell Youth Wrestling 2014-15 REGISTRATION BE A PART OF THE TRADITION
Registration Time:
Wednesday, October 15th 6:00pm – 8:00pm Saturday, October 18th 10:00am – NOON ***Online Registration is also available***
Place:
Huston Middle School Auxiliary Gym
Cost:
$70, payable to “Burrell Youth Wrestling” ($50 for 2ndchild, 3 or more $150 total)
Wednesday October 15th 7-8pm at HMS gym. We are hosting an open mat for any child interested in trying wrestling out before they sign up. Come out meet the coaches and the BYW Board as we answer any questions you might have. Wrestling is a competitive sport that helps to develop good character and sportsmanship qualities, as well as selfdiscipline, confidence, physical strength and stamina. Any child age 5 (by December 31st) up through 6th grade is eligible to sign-up with the Burrell Youth Wrestling program. A copy of the child’s Birth Certificate (first year wrestlers only) must be included with this registration form. The season begins the first week of November 2014 and will end in February 2015. Practices will be held at Huston Middle School two evenings a week, either Mondays & Wednesdays (more experienced wrestlers) or Tuesdays & Thursdays, from 6:30-8:30PM. At times, Friday evenings may be reserved for additional instruction. Matches and tournaments begin in December 2014 and end in February 2015 (March for the experienced). Please contact David Lacinski (724) 988.9401 or Mike Terranova (412) 480.4414 should you have any questions regarding the program. Online registration and additional information is available at http://www.burrellyouthwrestling.org. __________________________________________________________________________________________________ Child’s Name_____________________________________Date of Birth______________Age_________Grade_________ Home Address_____________________________________________School District Attending_____________________ Parent/Guardian 1______________________________Cell____________________Email_________________________ Parent/Guardian 2______________________________Cell____________________Email_________________________ Emergency Contact Name_____________________________Phone___________________________________________ Child’s Apparel Sizes: S/S T-Shirt______L/S T-Shirt______Hoodie______Shorts______Sweatpants______Jacket_______ Sizes: YS, YM, YL, AS, AM, AL, AXL______________________________________________________________________ NO CASH ACCEPTED, ONLY CHECKS OR MONEY ORDERS! FUNDRAISING: Each child must participate in both the raffle ticket and hoagie fundraisers along with collecting Super Trophy sponsorships. FUNDRAISING BUYOUT IS DUE AT REGISTRATION: $150 for the 1st child ($75 each additional sibling) You will still be required to work your volunteer shift at each event and collect Super Trophy sponsorships. In consideration of your acceptance, I/we waive and release the Burrell Youth Wrestling organization, Burrell School District, and anyone connected with this organization from any and all claims of damages for injuries or losses suffered by me/us, and I/we waive all damages against the sponsors of this organization and its board members. Parent Guardian Signature____________________________________________________Date_____________________
Registration Time:
Wednesday, October 15th 6:00pm – 8:00pm Saturday, October 18th 10:00am – NOON ***Online Registration is also available***
Place:
Huston Middle School Auxiliary Gym
Cost:
$70, payable to “Burrell Youth Wrestling” ($50 for 2ndchild, 3 or more $150 total)
Wednesday October 15th 7-8pm at HMS gym. We are hosting an open mat for any child interested in trying wrestling out before they sign up. Come out meet the coaches and the BYW Board as we answer any questions you might have. Wrestling is a competitive sport that helps to develop good character and sportsmanship qualities, as well as selfdiscipline, confidence, physical strength and stamina. Any child age 5 (by December 31st) up through 6th grade is eligible to sign-up with the Burrell Youth Wrestling program. A copy of the child’s Birth Certificate (first year wrestlers only) must be included with this registration form. The season begins the first week of November 2014 and will end in February 2015. Practices will be held at Huston Middle School two evenings a week, either Mondays & Wednesdays (more experienced wrestlers) or Tuesdays & Thursdays, from 6:30-8:30PM. At times, Friday evenings may be reserved for additional instruction. Matches and tournaments begin in December 2014 and end in February 2015 (March for the experienced). Please contact David Lacinski (724) 988.9401 or Mike Terranova (412) 480.4414 should you have any questions regarding the program. Online registration and additional information is available at http://www.burrellyouthwrestling.org. __________________________________________________________________________________________________ Child’s Name_____________________________________Date of Birth______________Age_________Grade_________ Home Address_____________________________________________School District Attending_____________________ Parent/Guardian 1______________________________Cell____________________Email_________________________ Parent/Guardian 2______________________________Cell____________________Email_________________________ Emergency Contact Name_____________________________Phone___________________________________________ Child’s Apparel Sizes: S/S T-Shirt______L/S T-Shirt______Hoodie______Shorts______Sweatpants______Jacket_______ Sizes: YS, YM, YL, AS, AM, AL, AXL______________________________________________________________________ NO CASH ACCEPTED, ONLY CHECKS OR MONEY ORDERS! FUNDRAISING: Each child must participate in both the raffle ticket and hoagie fundraisers along with collecting Super Trophy sponsorships. FUNDRAISING BUYOUT IS DUE AT REGISTRATION: $150 for the 1st child ($75 each additional sibling) You will still be required to work your volunteer shift at each event and collect Super Trophy sponsorships. In consideration of your acceptance, I/we waive and release the Burrell Youth Wrestling organization, Burrell School District, and anyone connected with this organization from any and all claims of damages for injuries or losses suffered by me/us, and I/we waive all damages against the sponsors of this organization and its board members. Parent Guardian Signature____________________________________________________Date_____________________
