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.