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JIM CARLS TAKEDOWN CANCER WRESTLING TOURNAMENT March 21, 2015 Hosted by: Lehigh Valley Chapter of PIAA Wrestling Officials William Allen Wrestling Program and Allen Youth Association Location: William Allen High School -‐-‐-‐ 126 N 17th St, Allentown, PA 18104 Free event t-‐-‐-‐shirt if registered by March 16, 2015. Jim Carls is a Wrestling Official with District XI, and involved in the wrestling community. Jim also is an Assistant Principal at Trexler Middle School and a dedicated community leader. Jim is a loving husband and father of four. Jim never smoked, never drank alcohol and ran 5 miles a day. In July 2013; Jim turned 45 and was diagnosed with Stage 4 Lung Cancer the very next day. His only symptoms were a cough and stiff back, but now, he's fighting for his life. Please help support Jim and his family. Thank you so much for your kindness and generous support. Grades: K – 12
Divisions: th Pre-‐-‐-‐Registrations Only, No walk-‐-‐-‐ons Wrestling begins at 8:30am Pee Wee: 5-‐-‐-‐6 years Bantam: 7-‐-‐-‐8 years Midget: 9-‐-‐-‐10 years Junior: 11-‐-‐-‐12 years (no 7th graders) th
th th Jr. High: 7 -‐-‐-‐8 Grades (No 9 Graders) High School: 9th–12th grades. Team of 10 or more wrestlers are available for a discount, contact us. Weigh-‐-‐-‐in: Honor system for all Divisions. Remember, teaching your wrestler honesty is more important than any wrestling victory. Please list your actual weight. Challenges: Challenges will be at the discretion of the tournament director. No refunds. Random weight checks will be conducted. Birth certificates required for age challenges. Bouts: Pee Wee-‐-‐-‐Jr. -‐-‐-‐ 1 min periods / Jr. High & High school -‐-‐-‐ 1.5 periods / Overtime -‐-‐-‐ 1 min & 30 sec ride out. Rules: Modified PIAA. Head Gear & Wrestling Sneakers are mandatory. Singlet is recommended. Awards: 1st, 2nd, 3rd place. Matches: Officiated by PIAA Officials Admission: Adults and Coaches $5.00 / Students $3.00. Registration: is $25.00. Online prior to tournament / Or send registration Postmark by: March 13, 2014 Register On-‐-‐-‐Line: www.eztourns.com/2015listings.php / Accepting Credit Card or PayPal payment. Or send registration Postmark by: March 13, 2014 Checks Payable to: AYA Mail registration to: Take Down Cancer Wrestling / 1722 W. Highland St. Allentown PA 18104-‐-‐-‐3130 Contact -‐-‐-‐ Phone: 484-‐-‐-‐602-‐-‐-‐5402 Email: [email protected] Jim Carls Takedown Cancer Wrestling Tournament / March 21, 2015 Wrestlers Name: Team: Email: Division: Address: State: _ T-‐-‐-‐Shirt Size: Actual Weight: Zip: Age: City: Phone: DOB: Persons are not allowed to participate in any Allen Youth Association / AYA activities unless they consent to the terms below. Please carefully review and complete the agreement below. A parent or legal guardian for each minor participating must read and agree to the following: I wish to allow my son/daughter/child under my legal guardianship (“child”), to participate in AYA activities. In consideration of AYA providing my child with the opportunity to participate in AYA activities, I hereby agree, for myself, my heirs, assigns, executors, and administrators, to be legally bound hereby and waive, release, and forever discharge AYA, Lehigh Valley Chapter of PIAA Wrestling Officials, THE COUNTY OF LEHIGH, THE CITY OF ALLENTOWN, AND THE ALLENTOWN SCHOOL DISTRICT and its nonprofit partner agencies, its officers and directors, members, partners, funders, employees, agents, and volunteers (“Releasees”) from any and all liability, causes of action, suits, proceedings, damages, judgments, claims and demands whatsoever arising out of my child’s participation in a AYA or AYA related activity. I am aware and agree that there are inherent risks of injury to my child, my child’s property and third parties arising from volunteer activities typically performed by Releasees, and which may be performed by my child as an AYA participant. I hereby give permission for my child to participate in all activities through AYA and expressly and specifically acknowledge that those activities may involve (a) physical activity (including without limitation work with heavy tools and materials), (b) contact with unidentified and unfamiliar persons, (c) travel to and from various unspecified locations, and (d) other potential risk of injury. Notwithstanding the preceding sentence, I willingly and freely assume all such risk and damage to person or property arising there from, whether or not resulting from negligence, and agree to release AYA and all Releasees from any and all liability, actions, causes of action, claims and demands of every kind and nature whatsoever which I now have or which may arise out of or in connection with my child’s participation in AYA or AYA related activities. Parent Signature:_ Print name: