Please provide the following contact information:

Participant's Name
Address
City
State
Zip Code
E-mail
Work Phone
Home Phone
Grade in Fall 2004
Age
Parents Name
Caretaker/ Ride
Any special medical conditions	Yes No
Please explain
Emergency Contact
Number
T-shirt Size	Youth L Adult S Adult M Adult L Adult XL Adult XXL
Liability Release I, the undersigned, individually and as a parent/guardian _____________________ a minor, ask that he/she be admitted to participate in the Commando Wrestling sponsored event.  I do hereby agree to release, discharge and hold harmless Hendersonville High School, their agents and employee of and from all causes, liabilities, and damages, claims, or demands whatsoever on account of any injury or accident involving the said minor arising out of the minor’s attendance in the camp I also give my permission for my child’s photograph to appear in promotional material regarding this event.	I have read and agree to the liability release Yes No