Indiana State Wrestling Association, Inc.
USA Wrestling Athlete's
Membership Card Application
 Click now for Membership Card Frequently Asked Questions....

Updated for 2010 Season
   
Only parents or guardians 18 years and older may complete this online membership application.   
ALL * FIELDS ARE REQUIRED.
ATHLETE'S INFORMATION
Last Name*    (Jr., II, III)
First Name*
Middle Initial   (If there is no middle initial, please use N/A.)
Address*
City*
State*
ZIP Code*
Phone Number* xxx-xxx-xxxx
(Please include area code. If no phone number is available, then please type in "none".)
Alt. Phone Number xxx-xxx-xxxx
(Please include area code. If no phone number is available, then please type in "none".)
Date of Birth*   mm/dd/yyyy
Age*
Gender*
Grade*
Club Affiliation*  (ISWA/USA member clubs only. If no club affiliation, please use N/A.)
Division*  
Approximate Weight*
Participating Style*
(Select all that apply.)

Folkstyle

Freestyle

Greco
PARENT OR GUARDIAN INFORMATION
(If you are 18 yrs. or older, please complete this section for yourself.)
 ALL * FIELDS ARE REQUIRED.
Last Name*
First Name*
Relationship to Athlete*
Day Phone Number* xxx-xxx-xxxx (Please include area code.)
Email Address*
 (We will not share nor sell your email address to any third party. 
This is strictly for our office use and for youth protection.)

Mandatory USA Wrestling Waiver and Release from Liability

  1. On behalf of myself, my heirs and next of kin, personal representative, agents, insurers, successors and assigns (all hereinafter “Releasors”), I hereby FOREVER RELEASE, DISCHARGE, AND COVENANT NOT TO SUE THE UNITED STATES OF AMERICA WRESTLING ASSOCIATION, INC., its insurers, its affiliated clubs, administrators, agents, directors, officials, state organizations, members, committees, volunteers, all employees of USA Wrestling, and any and all participants, officials, referees, coaches, host clubs, sponsoring agencies, sponsors, advertisers, local organizing committees (and if applicable) owners, lessors and operators of premises used to conduct any USA Wrestling sanctioned event, meet, practice or activity (all hereinafter “Releasees”) from any and all liabilities, claims, demands, causes of action or losses of any kind or nature, past, present or future, direct or consequential that I may hereafter have for PERSONAL INJURY, PERMANENT, TEMPORARY, TOTAL OR PARTIAL DISABILITY, DISFIGUREMENT, PARALYSIS AND ANY OTHER LOSSES OR DAMAGES TO PERSON OR PROPERTY OR DEATH, arising out of my participation in, attendance at or traveling to and from any USA Wrestling sanctioned event or activity including, but not limited to, LOSSES CAUSED BY THE PASSIVE OR ACTIVE NEGLIGENCE OF THE RELEASEES, or hidden, latent or obvious defects in the facilities or equipment used.
  2. Releasor understands and acknowledges that USA Wrestling activities and the sport of wrestling in general have inherent dangers that no amount of care, caution, training, instruction, supervision or expense can eliminate. RELEASOR EXPRESSLY AND VOLUNTARILY ASSUMES ALL RISK OF PERSONAL INJURY, PERMANENT, TEMPORARY, TOTAL OR PARTIAL DISABILITY, DISFIGUREMENT, PARALYSIS AND OTHER LOSSES OR DAMAGE TO PERSON OR PROPERTY OR DEATH, sustained while participating in, attending, preparing for or traveling to and from any USA Wrestling sanctioned event, meet, practice or activity, including the risk of PASSIVE OR ACTIVE NEGLIGENCE OF THE RELEASEES, or hidden, latent or obvious defects in the facilities or equipment used.
  3. Releasor acknowledges and fully understands that each participant in any USA Wrestling sanctioned event, meet, practice or activity , including Releasor, will be engaging in activities that involve risk of serious injury, including permanent, temporary, total or partial disability, disfigurement, paralysis and any other losses to person or property, including death, and that severe social and economic losses may result not only from Releasor’s own actions, inactions or negligence of others notwithstanding the rules of play or the condition of the premises or of any equipment used. Further Releasor acknowledges and fully understands that there may be other associated risks with such activities which are not known or not reasonably foreseeable at this time.

I ACKNOWLEDGE THAT I HAVE HAD SUFFICIENT OPPORTUNITY TO REVIEW THE PROVISIONS OF THIS DOCUMENT AND UNDERSTAND ITS PURPOSE, MEANING AND INTENT.

By submitting this application electronically, I do hereby represent I am, in fact, the parent or legal guardian of athlete as indicated on this application and acting in such capacity agree to the terms and conditions of the above stated waiver and release.