Tommy Rowlands- 2X National Champion, 4X All American at tOSU
Joel Greenlee- OU Head coach, coached 13 All Americans, 3X MAC Champions, national runner up and 2X All American at Northern Iowa
Keaton Anderson- 3X Ohio state champion, NCAA All American at tOSU
Josh Demas- 2X Ohio state champion, 3X NCAA national qualifier at tOSU
When: June 15th-18thTime: 5 PM-8 PMWhere: Big Walnut High School Wrestling Building, 555 S. Old 3C HWY, Sunbury, OH 43074Cost: $85/camper, $75 if pre-registered (cost includes 4 great clinicians and camp t-shirt provided by Rudis)Pre-Registration must be sent in by June 8th
______________________________________________________________________________________Please fill out the information below and send with payment to:
Luke Moore, Big Walnut High School, 555 S. Old 3C HWY, Sunbury, OH 43074checks can be made payable to Big Walnut WrestlingE-mail Luke Moore with any questions at [email protected]
Name_________________________________________ Grade_______ Age________ Weight________Address____________________________________________ Home School_______________________
Parent/Guardian Name__________________________________ E-Mail____________________________
Shirt Size (circle one) YS YM YL AS AM AL AXL AXXL AXXXL
We, the undersigned, understand that this camp is not a school activity. In addition, we hereby state that we are aware that participation in all sports requires an acceptance of risk of possible injury. In giving our consent for our son/daughter to participate, we are aware that the risk of injury may be severe including fractures, brain injuries, paralysis, or other severe complications. Additionally, we agree not to hold the Big Walnut School District liable for any injury incurred by our son/daughter while in attendance of camp.
In case of an emergency, and you cannot be reached, whom should we contact?
Name__________________________________Phone #__________________________________
Are there any health problems that we should be aware of?
Family Doctor_____________________________ Phone #______________________________
I ___________________________mother/father/guardian__________________________
(Parent/guardian’s name) (Student’s name)
give permission for the instructors at the Wrestling Camp to obtain any necessary medical, vision, or dental care for my child. This permission is for June 15nd- June 18th inclusive. The camp sponsors do not provide medical or dental insurance for students injured in camp activities. We, the undersigned, do have insurance or accept full payment responsibility for any and all medical and/or dental expenses resulting from any injury which he/she may suffer while taking part in camp.
Parent/Guardian Signature_______________________ Date __________
