Email *
Date of Birth *
Graduation Year (4 digits) *
Weight *
Street Address *
City, State, Zip *
Phone Number *
School *
Select Camps you're attending * HS/Jr High Fall Laser Focus Mat Camp Fall Laser Focus Youth Camp
Accomplishments / experience level *
We can not guarantee partners of the same size. Right now while you are thinking about it, contact an athlete close to your size and encourage them to register and train with you. * I understand completely I'm contacting my buddy now!
For the health safety and well-being of myself, as well as other wrestlers, I agree to abide by all aspects of the Attack System Camp Health protocol * I agree I strongly agree
I agree to hold harmless Randy Simpson, staff, and property owners, from and against any injuries sustained by the participant. The understanding hereby releases, waives, and forever discharges Randy Simpson and Randy’s Attack System Wrestling, LLC, from and against any and all claims, injuries, demands, actions, or cause of actions arising out of the participation by the athlete in Randy’s Attack System Programs. I authorize the program director and/or staff to act in my behalf regarding any situation requiring discipline or medical attention. My son is physically fit to participate in this program, according to his family doctor. I understand that payment arrangement is due before attending sessions. We do not Pro-rate for missed sessions. * I agree I completely and wholeheartedly agree
Injury Policy: We don't offer refunds for folks who just plain don't show up. However, If your athlete cannot attend due to a medical issue, and you include documentation from a doctor at least THREE weeks prior to the START of Camp, a CREDIT may be applied for future training, minus a processing fee of $100. * **No Refunds once the camp has begun** I agree I wholeheartedly agree
Video release: I hereby grant permission to Randy’s Attack System Wrestling, LLC, the rights of my child’s image, in video or still, and of the likeness and sound of their voice as recorded on audio or video without payment or any other consideration. I understand that my child’s image may be edited, copies, exhibited, published or distributed and waive the right to inspect or approve the finished product wherein my child’s likeness appears. Additionally, I waive any right to royalties or other compensation arising or related to the use of my child’s image or recording. I also understand that this material may be used in diverse educational settings within an unrestricted geographic area * I agree Sure, make me a video star!
I understand payment (or a payment plan) is required prior to attending a workout, and I agree to fully honor any payment plan I sign up for. * I agree I completely agree
Name of Parent/Guardian agreeing to the above *