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Building great athletes & better people!

Southern Oklahoma Wrestling Academy

Please fill out the form below to register for our wrestling program.

Participant Information

Full Name *

Date of Birth *

Age *

Gender *

Male

Female

School Name *

Grade level *

Contact Information

Parent/Guardian Name(s) *

Phone Number (Primary) *

Phone Number (Alternate)

Email *

Address 1 *

Address 2

City *

Zipcode *

Medical Information

Doctor’s Name *

Doctor’s Phone

Health Insurance Provider *

Policy Number *

Medical Conditions *

Medications Currently Taking *

Emergency Contact (Other than parent/guardian)

In case of emergency, we will call 911 and notify the emergency contact listed below.

Name *

Relationship to Participant *

Phone Number *

Program

Selection by Age *

Little Grapplers (Ages 4-6)

Youth (Ages 6-12)

Junior High (Ages 12-15)

High School (Ages 15-18)

Acknowledgments & Signatures

I, the undersigned parent or guardian of the above-named participant, hereby release the Southern Oklahoma Wrestling Academy, its coaches, staff, and volunteers from any and all liability for injuries or illness that may occur during training, practice, events, or travel. I understand the risks involved in wrestling and give permission for emergency medical treatment if needed. *

Media Release

I give permission for my child’s photo/video to be used for promotional purposes.

I do NOT give permission for media use.

Signature of Parent/Guardian *

Date *

Waiver

Please print and sign the following waiver.

Waiver Here