Wrestler & Household Info | Medical Consent and Release of Liability Waivers | Cory Clark Wrestling

Medical Consent and Release of Liability Waivers

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Wrestler & Household Info
Medical Consent & Liability Waiver
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Wrestler & Household Info

Medical Consent & Release of Liability Waiver Form

Please Download, Sign, Upload - Medical Consent & Release of Liability Waiver Form

Upload SIGNED Medical Waiver HERE:*

Wrestler Information

First Name:*

Middle Name:

Last Name:*

Address:*

State:

City:*

Zip / Postal Code:*

Date of Birth:*

Gender:*

USA Wrestling Membership - REQUIRED YEARLY

USAW Website ← CLICK HERE

USAW ID Number.:

Upload USAW ID CARD:*

Parent/Guardian First Name:*

Parent/Guardian Last Name:*

Parent/Guardian Cell Phone:*

Parent/Guardian Email:*

USAW ID Number: