2019 Cobra/SWIFT Wrestling Clinic

Online registration

November 3, 2019

At Council Bluffs Abraham Lincoln High School
1205 Bonham Stree



First Child

mm/dd/yyyy

Second Child ?

First Name Last Name
mm/dd/yyyy

Third Child ?

First Name Last Name
mm/dd/yyyy

I hereby give my full permission to my (son/daughter) to participate in Cobra Optimist Wrestling Club of Council Bluffs (Cobra) activities. I agree to assume full responsibility in case of accident or injury while (he/she) is playing/competeing/wrestling, traveling to or from the scheduled area, or representing (his/her) team in any manner, and do further hereby release and hold forever harmless Cobra, its agents and employees, from any liability for any personal injuries, including death or property damage, which may be incurred by my child while playing/competeing/wrestling, traveling to or from the scheduled area, or representing the team in any manner, including but not limited to any claim alleging that the injury or damage was caused by defective equipment owned or furnished by the Cobra, or by negligence in the supervision of my child or others. It is the responsibility of each parent or guardian to check their child's insurance for athletic injuries. This signature gives us permission to seek emergency medical care as deemed necessary. This signature also allows Cobra to post pictures on Facebook or our website that have been taken during Cobra activities.