Print , read, sign and bring with you:                                                                     Blazer Youth Wrestling Camp 2008                                                                              Release / Waiver of Claims I/We the parent(s)/guardian(s) of the below-named athlete, who is a candidate to attend the 2008 BLAZER YOUTH WRESTLING CAMP, do hereby give my/our approval to my/his/her participation in all of the activities of the BLAZER YOUTH WRESTLING. I/We assume all risks and hazards incidental to the conduct of the activities and transportation to and from the associated activities. I/We do hereby release, absolve, indemnify, and hold harmless Coach Todd C. Marshall and the CLARK COUNTY SCHOOL DISTRICT, as well as the organizers, sponsors, volunteers, coaches, supervisors, and school officials. In case of injury to my/our child, I/we hereby waive all claims against the organizers and of any of the supervisors/coaches/assistants appointed by them. To date, I/we have no knowledge of any medical problems or conditions that might endanger or preclude the participant from participating in this activity. Any other medical conditions, which I agree are not serious enough to preclude my/our child’s participation in the activities of the BLAZER YOUTH WRESTLING CAMP, are noted below. If the participant is currently under a doctor’s care, I/we will consult the participant’s physician prior to his/her participation. In signing this Release / Waiver (below) without refund. DO YOU HAVE MEDICAL INSURANCE – CHECK ONE? NO: ___ YES: ___ POLICY HOLDER’S NAME: ______________________________________________________________________________ NAME OF INSURANCE COMPANY: _______________________________________________________________________ INSURANCE COMPANY ADDRESS: _______________________________________________________________________ INSURANCE COMPANY POLICY NUMBER: _______________________________________________________________ DOES YOUR CHILD HAVE ANY EXISTING MEDICAL CONDITIONS? NO: ___ YES: ___ IF YES, PLEASE EXPLAIN: __________________________________________________________________________________________ ATHLETE’S PRINTED NAME: ATHLETE’S SIGNATURE: PARENT’S / GUARDIAN’S PRINTED NAME: PARENT’S/GUARDIAN’S SIGNATURE: DATE: