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Registration Form | Punishers Wrestling

Pride. Character. Discipline.

Punishers Wrestling

Training with Collin Kerr

Punishers Wrestling

Registration Form


    Fill in your details into the form below.

    Applicants First Name:

    Last Name:

    Your Email (required):

    Your Contact Number (required):

    Gender:


    Address:

    Street Name:

    Suburb:

    State/Province:

    Post Code:


    Additional Information:

    Medical requirements:

    If you (the applicant) are a wrestler, do you have a managed medical condition for which an emergency plan is required?

    Please provide summary details of managed medical condition.

    Name of person who agreed to Terms of registration. (This is a parent/guardian if applicant is a minor):

    Parent/Guardians Name:

    Contact Number:

    Relationship to applicant:

    Parents Work Number:


    Attendance:

    Which days are you most likely to attend? (This is to help cater to the needs of the lesson plan)
    TuesdayFridaySaturday


    Media:

    I give permission for Punishers Wrestling to use photographs or video footage of me or my child for use in promotional materials both online and print.
    Yes

    * All information submitted is for Punishers Wrestling and WrestlingWA only and will not be shared with any third parties.