Waiver

BULLOCH ELITE TRAINING CENTER

MEMBERSHIP WAIVER & RELEASE OF LIABILITY

WRESTLER INFORMATION

Wrestler’s Name: _____________________________________________
Age: ___________
Date of Birth: _________________________
Approximate Weight: ___________
Siblings Who Wrestle: ____________________________________________________________

Grade: ___________
School: _________________________________________________________________________
Number of Years Wrestling: ___________
How did you hear about Bulloch Elite Training Center/BBWC?

PARENT/GUARDIAN INFORMATION

Parents/Guardians’ Names: ________________________________________________________
Contact Numbers: ________________________________________________________________
Email Addresses: _________________________________________________________________
Emergency Contact Name: _________________________________________________________
Emergency Contact Number: _______________________________________________________
Relationship to Wrestler: __________________________________________________________

MEDICAL INFORMATION

USA Wrestling #: ________________________ Exp. Date: ___________
Allergies: ________________________________________________________________________
Special Needs: ___________________________________________________________________
Concerns: _______________________________________________________________________
Health Insurance Carrier: ________________________________________
Policy Number: _______________________________________________
Insured’s Name: ______________________________________________

ASSUMPTION OF RISK, WAIVER, AND RELEASE OF LIABILITY

By signing this document, I acknowledge that I am voluntarily participating in activities at Bulloch Elite Training Center (the "Facility") and understand the risks associated with wrestling, strength training, and related athletic activities.

1. Acknowledgment of Risks

I understand that participation in training, wrestling, and athletic activities involves inherent risks, including but not limited to:

  • Muscle strains, sprains, fractures, or other physical injuries
  • Risk of head injuries, concussions, or other trauma
  • Possible exposure to communicable diseases, including but not limited to COVID-19
  • Any other injuries or health complications that may arise from participation

I voluntarily assume all risks associated with participation at the Facility.

2. Release of Liability

I, on behalf of myself (or my minor child), my heirs, executors, and representatives, hereby release, waive, discharge, and hold harmless Bulloch Elite Training Center, its owners, coaches, trainers, staff, affiliates, and any associated entities from any and all liability, claims, demands, actions, or causes of action related to injury, illness, or property damage that may occur during participation at the Facility.

3. Medical Authorization

In the event of an emergency, I authorize Bulloch Elite Training Center staff to seek emergency medical treatment on my behalf if I am unable to do so. I agree to assume financial responsibility for any medical treatment provided.

4. Code of Conduct

I agree to abide by all Facility rules and policies, respect staff and fellow participants, and follow safety guidelines. Any violation may result in termination of membership without refund.

5. Zero Tolerance Policy

Bulloch Elite Training Center maintains a Zero Tolerance Policy for inappropriate behavior, misconduct, or violations of Facility rules. This applies to both participants and parents/guardians.

Violations include, but are not limited to:

  • Disrespectful or aggressive behavior toward staff, coaches, athletes, or other parents
  • Verbal abuse, harassment, bullying, or intimidation of any kind
  • Disrupting training sessions or interfering with coaching
  • Unsportsmanlike conduct during practices, competitions, or events
  • Any action that jeopardizes the safety, well-being, or integrity of the Facility and its members

Bulloch Elite Training Center reserves the right to immediately dismiss any participant or parent from the club and terminate their membership without refund if they violate this policy.

Parent/Guardian Initials:______

Members Initials (if 10 years or older):_______

By signing below, I acknowledge that I have read and agree to abide by the Zero Tolerance Policy and understand that failure to do so may result in immediate dismissal from the program.

6. Photo & Media Release

I grant Bulloch Elite Training Center permission to take photographs, videos, and other media recordings of me (or my minor child) during training, competitions, and events. I understand these images may be used for promotional materials, social media, website content, or other marketing efforts.

I waive any right to compensation or ownership of these images and release Bulloch Elite Training Center from any claims related to their use.

☐ I agree to the Photo & Media Release.
☐ I do NOT agree to the Photo & Media Release.

Participant’s Name: _______________________
Signature: _______________________
Date: _______________________

(For minors, a parent or legal guardian must sign below.)

Parent/Guardian Name: _______________________
Signature: _______________________
Date: _______________________

7. Parental Consent (For Minors Only)

If the participant is under 18 years old, a parent or legal guardian must sign below:
I, the undersigned parent/guardian, understand the risks involved in my child’s participation and agree to the terms outlined above.

Parent/Guardian Name: _______________________
Signature: _______________________
Date: _______________________

8. Agreement & Acknowledgment

I have carefully read and fully understand this waiver, release, and Zero Tolerance Policy. I voluntarily sign it, understanding that I am waiving legal rights.

Participant’s Signature: _______________________
Date: _______________________

*PLEASE PRINT THIS PAGE, FILL IT OUT AND BRING IT WITH YOU TO YOUR FIRST TRAINING SESSION