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The NCWWA Wrestler Registration Form
Wrestler Bio:
School: *
School Code:

Required
City/State: *
Required
Wrestler Name: *First:
Required
Last:
Required
Current Age: *
Required
I competed in the NCWA during: 1997,1998,1999 *
1st Year:

Checkboxes or text Required
Expected Weight: *
Required
I competed in the following association(s): (check all that apply) *NONE: NCAA:
NAIA: NJCAA:
Required
Wrestler's e-mail Address: jim@ncwa.net
Required
Wrestler's Home Phone #: (555) 555-5555
Required
Date of Birth: 02-25-80
Required
High School: *
Required
City/State: *
Required
Highschool Graduation Year: 1996
Required
Month/Year first entered Any college/university: 06/96
Required
Former College name and City/State:
If applicable
Wrestler's Current Academic Status (circle one): * Freshman Sophomore
Junior Senior
Graduate
Required
Emergency Contact Info:
Name:Phone #:
Relationship:
Wrestling Plan Acknowledgment:
I, the undersigned, do hereby acknowledge that I have read, with understanding, the current edition of the NCWA Wrestling Plan, and I agree to abide by all of the articles of the Plan. Wrestling Plan
Wrestler's Acknowledgment: Yes I Agree
Required
NO I Reject
Wrestler Waiver and Release of Liability Acknowledgment:
I, the undersigned, do hereby acknowledge that I have read, Understood and Agree to the "Wrestler Waiver and Release of Liability" (WWRL). I agree to abide in spirit and in law by all of the tenants included in the WWRL. View the form before agreeing. Review Waver/Liability Form
Wrestler's Acknowledgment: Yes I Agree
Required
NO I Reject
Wrestler's Insurance Acknowledgment:
It is understood that All wrestlers must carry some type of medical insurance before registering with the NCWA as a participant. Individuals may carry health insurance through their parents, their school, or have a personal injury policy. The NCWA, as an organizational body, cannot accept any liability for athletes during practice, travel and/or competition. Every athlete must sign this acknowledgement concerning the above policy before practicing or competing in any NCWA activity.
Wrestler's Acknowledgment: Yes I Agree
Required
NO I Reject
Health Insurance Information:
Proof of Insurance is Required
Carrier:Policy #:
Eligibility Acknowledgement:
Coach's Name Printed: *
Required
Coach's Signature:___________________________________
Administrator's Name Printed:
Required
Administrator's Signature:___________________________________
Wrestler's Name Printed:
Required
Wrestler's Signature:___________________________________
Wrestler Bio Acknowledgement:
The above information that is marked with * denotes fields that will be used to create a wrestler bio page for all to see. No Confidental information will be included in your bio. ie SS# Phone # . Only information designated by an * will be included in your bio on the web site for all to see. You may request we remove your bio from public view at any time.
Wrestler's Bio Acknowledgment:
Yes or No is Required
The * denotes fields that will be in the bio
Yes Include My Bio No Do Not Include My Bio