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Southern Champs Wrestling Camp - June 11 - 13


CoachPSimpson
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This will be the 25th year this camp has been around. It will be another excellent few days of wrestling led by some top technicians/competitors including Phillip SimpsonOne wrestler at camp will receive a free home-size wrestling mat complements of Dollamur Sports Surfaces.

Southern Champs Wrestling Camp

25th Year, 1993 – 2018

 In partnership with Dollamur Sport Surfaces 

June 11, 12, 13

9 – 4p

held at Montgomery Bell Academy

 

For rising 6th – 12th graders

 

Lead Instructors

Phillip Simpson 3X NCAA DIV I All-American (2005 Runner-up), 2012 Pan American Champion for Team USA, 4X TN State Champion

Garrett Schaner – 2015 NCAA DIV I Qualifier, 4 year starter at Stanford University, 4X HS Michigan All-Conference first team selection

 

* One wrestler at camp will receive a free home-size wrestling mat complements of Dollamur Sports Surfaces.

 

APPLICATION

Wrestler’s name: __________________________________________________________  Age:________________

Address: ______________________________________________City: ________________ Zip: _______________

Email: ____________________________________

School: ___________________________________________Grade entering in the fall of 2018: _______________ 

Parents’ Name: ____________________________________________  Daytime phone #: _____________________

In case of an emergency, if parents listed above cannot be contacted please call:

Name: ____________________________________________  Daytime phone #: ____________________________

Medical information which the camp should know:

_____________________________________________________________________________________________

                                                                 

Nashville Camp (MBA) June 11, 12, 13                                                                                                                                             

Mail this form with Check ($125 per wrestler for pre-registration.  $150 per wrestler for day-of-registration)

Make checks  payable to: 

SCWC

136 Ridgeside Road

Chattanooga, TN 37411

                                                                    T-Shirt Size:  XS   S   M   L   XL   2XL   3XL

                                                                                                  please circle shirt size

 

                    Agreement, Understanding and Release

(Must be signed by Parent or Guardian before wrestler can participate)

In consideration of this application by SOUTHERN CHAMPIONS WRESTLING CAMP, undersigned, as parent or guardian, understands, agrees, and acknowledges as follows:

 

1. Neither SOUTHERN CHAMPIONS WRESTLING CAMP nor the host school Montgomery Bell Academy provide insurance coverage for enrolled wrestlers against expenses of accident, injury, or illness suffered while enrolled in camp; enrollment and participation is at the sole risk of the enrolled wrestler and his parent or guardian.

2. In any event involving the undersigned's child and requiring emergency medical treatment or hospital admission, under such circumstances as not to allow timely contact between camp officials and undersigned, this will authorize camp officials to take such action as they deem necessary in the medical treatment of the undersigned's child      

3. This will further serve as full release and discharge for the Camp and its officials from any and all liability from loss, damage, or injury suffered by the child or undersigned arising out of, or loss while child or undersign is enrolled; undersigned will indemnify the Camp and its directors and hold them harmless against claims or suits made or brought by anyone on account of such injury, illness or loss.

 

Date:_______________________Parent/Guardian_______________________________________________________________    

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