Dual Trip Form

Dual Trip Form

Elite Athletic Club Trip Form Athlete Name:___________________________________ 

DIVISION/AGE: 
WEIGHT CLASS: 
ADDRESS: 
PHONE/EMAIL ADDRESS: 
GRADE/SCHOOL: 

PARENTS CONTACT INFORAMTION: 
EMERGENCY MEDICAL INFORMATION: 
ALLEGRIES: 
INSURANCE INFORMATION: 

AMATEUR & ATHLETIC WAIVER AND RELEASE OF LIBILITY: In consideration of being allowed to participate in any way with Elite Athletic Club LLC, athletic/sports program and related activities the undersigned: A. Acknowledge and fully understand that each participant will be engaging in activities that involve risk of serious injury, including permanent disability, death and severe social economic losses which might result not only from their own actions, inaction or negligence of others, the rules of play or the condition of the premises or of any equipment used. Further that there may be risks not know to us. B. Assume all the foregoing risks and accept personal responsibility for damages following such injury, permanent disability or death. C. Release, waive, discharge and covenant not to sue Elite Athletic Club LLC, its affiliated clubs, their respective administrators, directors, agents, coaches and other employees of the organization, other participants, sponsoring agencies, sponsors advertisers and if applicable, owners and leasers of the premises used to conduct an event/travel to an event, all of which are here after referred to as “releases” from demands, losses or damages on account of injury, including death or damage of property, causes or alleged to be caused in whole or in part by negligence of Elite Athletic Club LLC. D. In the event the Elite Athletic Club bus is utilized, this document acts as a release of liability for any damages, injury, disability or death in any event involving the bus. E. Agree to carry personal health insurance in case of sports injury. F. Release Elite Athletic Club LLC and expressly assume to risk and damages; and will indemnify and hold harmless Elite Athletic Club LLC as to any claims for injury and damage G. Understand that No refunds will be given for Deposits after specific date provided. H. Participant is not guaranteed a number of matches per meet. I. If the participant does not follow the rules of conduct they are subject to be sent home if parents are not on the trip, no refunds will be given if the participant breaks the rules of conduct. Parent/Guardian Signature: ____________________________________________ Date:______________ Rules of Conduct: No tobacco, drugs, or alcohol will be tolerated. For a violation of this rule, participant will be sent home, at the cost to their guardians. Due to such violation, no refund will be made. Vehicle to and from each event is a team bus. Therefore, respect to others is mandatory. High School athletes are the role models for our Middle School and elementary athletes. Act accordingly. Athletes are not allowed to leave the premises of an event or housing without permission or without being with a coach or chaperone. No athlete is to be swimming alone. At 10 PM, lights are out and you are to be in your designated space to sleep. Mandatory roll call will be posted daily. Do not be late. You primarily came to wrestle and have fun, but your focus is on wrestling. Athlete Signature:____________________________________________
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