REGISTRATION

Registration - Rancocas Valley Youth Wrestling Association Registration 2026-2027

Rancocas Valley Youth Wrestling Association Registration 2026-2027

Please complete all of the required fields below to register your son(s)/daughter(s) for the Rancocas Valley Youth Wrestling Associations (RVYWA).

Guardian Name

Registrant Address

City, State Zip

Guardian Phone

Guardian Email

Wrestler Information (1)

Wrestler First Name

Wrestler Last Name

Date Of Birth (MM/DD/YYYY)

Wrestler School Grade

Wrestlers Prior Years Experience

Age (as of 12/31/26)

Wrestler Estimated Weight

Singlet Size

Apparel Size

Wrestler #2 Information *If Applicable

Wrestler First Name

Wrestler Last Name

Date Of Birth (MM/DD/YYYY)

Wrestler's Prior Years Experience

Age (as of 12/31/26)

Wrestler School Grade

Wrestler's Estimated Weight

Singlet Size

Apparel Size

Medical Insurance Information

Parent/Guardian First & Last Name

Primary Insurance Company

Primary Policy Number

Primary Insurance Effective Date (MM/YYYY)

Secondary Insurance Company (If Applicable)

Secondary Policy Number (If Applicable)

Secondary Insurance Effective Date (If Applicable)

Emergency Medical Information (Please list allergies, pre-existing conditions and/or special medical information)

Emergency Contact Information

Emergency Contact First & Last Name

Relationship to Wrestler

Emergency Contact Phone

Volunteer

Coach (Any person who wishes to help coach must pass background check and safe sport certification via USA wrestling

Concessions

Registration fee per wrestler

	$150.00
Quantity:

Registration fees are for your child to participate in the 26-27 season. This fee includes team gear and singlet. This also includes all regular season matches. The post season tournament(s) may be an additional fee depending on our league.

Registration Fee K-5

	$100.00
Quantity:

Registration Fee 6th-8th grade

PARENT/GUARDIAN CONSENT AND WAIVER

I, the parent or guardian, hereby give consent for this participation in the Rancocas Valley Youth Wrestling Association (RVYWA) during the 2025-2026 season. I assume all risks and hazards incidental to such participation, including transportation to and from any and all activities related to the wrestling program; and I do hereby waive, release, absolve, indemnify, and agree to hold harmless the RVYWA: the Township of Mt. Holly; Rancocas Valley Regional High School; the coaches, staff, and volunteers associated with the wrestling program; the participants and people transporting my child/children to and from activities from any claims arising from any injury to my child/children. I further give consent for emergency care prescribed by a duty licensed MD, DO, or Dentist. This care may be given under whatever conditions to preserve the life, limb, or well being of my child.

AUTHORIZATION FOR EMERGENCY MEDICAL TREATMENT

I, the parent(s) and/or guardian(s) of Rancocas Valley Youth Wrestling Association (RVYWA) wrestler(s), hereby authorize emergency medical treatment for my son(s)/daughter(s) while wrestling with the RVYWA in the event of an injury that occurs while my son(s)/daughter(s) is at practice or competition. If emergency medical aid is necessary, I give permission/consent for medical professionals to treat my son(s)/daughter(s) if I am not present at practice or competition. I understand that the RVYWA board members and/or coaches will notify me as soon as possible if I am not present if an injury occurs which requires emergency medical treatment. I understand that I am required to be present once I am notified of any injury that requires emergency medical treatment.

PARENTS' CODE OF ETHICS

I hereby agree to the following for my child participating in the Rancocas Valley Wrestling Program by following the Parents’ code of Ethics:

I will inform the coach of any physical disability or ailment that may affect the safety of my child or the safety of others.

I will praise my child for competing fairly and trying hard, and stress that doing one’s best is more important than winning, so that my child will never feel defeated by the outcome of his performance.

I will never ridicule or yell at my child for making a mistake or losing. I will place the emotional and physical well being of my child ahead of a personal desire to win.

I will emphasize the importance of practices and how they will benefit skill development.

I will insist that my child wrestle in a safe and healthy environment that is free of drugs, tobacco, and alcohol and will refrain from their use at all practices and matches.

I will remember that the sport is for youth, not for adults and I will do my very best to make the program fun for my child.

I will ask my child to treat other wrestlers, coaches, fans and officials with respect.

At matches, I (and my guests) will encourage good sportsmanship be a positive role model and demonstrate respect and support for all wrestlers, coaches, and officials in order to encourage a positive experience for all.

At matches, I (and my guests) will not engage in any unsportsmanlike conduct with an official, coach, wrestler, or parent such as booing, taunting; refusing to shake hands; throwing headgear or using profane language or gestures. I will respect the officials and their authority during matches and will never confront them.

I will refrain from coaching my child or other players during matches and practices, unless I am one of the official coaches of the team and will
refrain from stepping on the mat unless requested by the Rancocas Valley Coaching staff.

Parents are required to know all practice/match schedules and times. Be aware, times and schedules are subject to change.

I agree that if I fail to abide by the aforementioned rules and guidelines, I will be subject to disciplinary action that could include, but is not limited to the following:
- Verbal warning by official, board member, and/or coach
- Removal from a gym by an official
- Parental season suspension

MEDIA RELEASE

I hereby give permission to the Rancocas Valley Youth Wrestling Association (RVYWA) to use, publish, reproduce photograph(s) of my son(s)/daughter(s) for flyers, newletters and the website. RVYWA or the photographer will not name any child in any photos.

I have read and agree to all terms and conditions above

Parent or Guardian Initials for Consent