2015 G-Trained Wrestling Camp G-Trained/4 Seasons Member Cost: $225 Non Member Cost: $275 Date: July 27th— 31st Time: 8:00am-4:00pm Age Groups: 6-10, 11-13, 14-18 Personal Information Camp staff: Davey Blake—Head Coach McDaniel College Josh Fitch—Assistant Coach McDaniel College Mason Goretsas—Assistant Coach McDaniel College Tom Goretsas—Head Coach Manchester Valley High Tim Lienau—Assistant Coach Manchester Valley High Name:____________________________________________ Age Group: 6-10 11-13 14-18 Parent/Guardian Name:______________________________ Email:______________________________________ Home Phone:_______________________________ Cell Phone:_________________________________________ Address:______________________________________________________________________________________ City:___________________________________ State:________ Zip Code:_________________________________ Approximate Weight Class:_________________________ Shirt Size:_____________________________________ Campers Birth Date:________________ Campers age at time of Camp:______ Camper’s Grade in Fall 2015:_____ School:___________________________________________ Coach’s Name:_______________________________ Waiver I, parent or guardian of __________________, am familiar with the risks inherent in participation in the Wrestling Camp activities. I release G-Trained Wrestling, Four Seasons, and its employees from any and all claims, demands and causes of action resulting from participation in the camp. I hereby authorize the staff to act for me according to his/her best judgment in an emergency requiring medical attention. Parent/Guardian Signature:___________________________________ Date:__________________________ To Register Mail in registration form to: Four Seasons 2710 Hampstead Mexico Rd Hampstead, MD 21074 with checks made payable to Four Seasons. To pay by Credit Card or Cash bring form into the Main front desk or call 410-239-3366 to pay over the phone. Deadline to register is a week prior to camp start. For more information on the G-Trained Wrestling Club and complete camp details please visit www.4seasonssportscomplex.com/g-trained/. For Staff Use Only Amount Paid:______________ Date Paid:__________________ Management Initials:_______________