Patriot Wrestling Club

2014
Freehold Township Parks & Recreation Commission
2015
Patriot Wrestling is a program endorsed by Freehold Township High School.
The program will be paced for all participants' skill and grade levels,
from "beginner" to "advanced.” Limited to 50 participants.
Equipment Required: Wrestling shoes and head gear.
Boys & Girls Grades K - 8
Location: Freehold Twp. High School Wrestling Gym
Director:
Jason
Dubnik
(entrance on left side of the building)
Times:
6:30 p.m.—8:00 p.m.
Dates: Mondays and Tuesdays, November 17, 2014—February 24th, 2015
Matches will be held on various Thursdays for all participants.
(20 Classes) No Classes on 12/22, 12/23, 12/29, 12/30, 1/19 & 2/16
Program Fee: Includes Singlet and T-Shirt
Residents $120.00 Non-Residents $160.00
For more information please contact the Recreation Office at 732-294-2190.
Office Hours are 8:30 a.m. to 4:30 p.m. Monday—Friday.
Registration is available online at www.freeholdtownshiprec.com.
Mail Registration Form to: Freehold Twp. Recreation, 1 Municipal Plaza, Freehold, NJ 07728 (Patriot Wrestling)
Participant’s Name ____________________________________________ Phone #____________________
Address_______________________________________________ Parent’s Cell #____________________
Mandatory Email Address (Print Clearly) _____________________________________________________
Age _______ School _______________ Grade_________ Birthdate ______/______/______
Sex: M / F
Medical Conditions: ______________________________________________________________________
Print Parent or Guardian’s Name ____________________________________________________________
Fee: ________ Cash/Check #/CC Approval #____________________ (Credit Card accepted in person or online)
Shirt Size: (circle one) CHILD M L
Singlet Size: (circle one)
Singlets will be ordered based on size selected.
Freehold Township will not be
responsible for incorrect size selection.
ADULT S M L
CXS
CS
CM
CL
45-60 LBS.
60-75 LBS.
75-85 LBS.
85-95 LBS.
AXS
AS
95-115 LBS. 115-135 LBS.
**CODE OF CONDUCT ON BACK MUST BE SIGNED BY PARTICIPANT AND PARENT/GUARDIAN.**
I UNDERSTAND THAT I AM PARTICIPATING AT MY OWN RISK AND THAT FREEHOLD TOWNHIP RECREATION WILL NOT ISSUE A REFUND IN
FULL OR PART FOR THIS PROGRAM. I AGREE TO HOLD HARMLESS THE TOWNSHIP OF FREEHOLD, RECREATION COMMISSION OR AUTHORIZED
AGENTS FOR ANY INJURY I MAY INCUR BY PARTICIPATING IN THIS PROGRAM.
_______________________________________________ ___________________
PARTICIPANT’S SIGNATURE (PARENT OR GUARDIAN IF UNDER 18)
DATE
16.
15.
14.
13.
12.
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10.
9.
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8.
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**If participant is under 18 both signatures are required .
No registration will be processed without properly completed forms.
________________________________________________________
Parent or Guardian Signature if participant is under 18 Date
________________________________________________________
Participants Signature
Date
I will not engage in unsportsmanlike conduct with any coach, parent,
player, participant, official or any other attendee.
I will not encourage my child, or any other person, to engage in unsportsmanlike conduct with any coach, parent, player, participant,
official or any other attendee.
I will not engage in any behavior which would endanger the health,
safety or well-being of any coach, parent, player, participant, official or
any other attendee.
I will not encourage my child, or any other person, to engage in any
behavior which would endanger the health, safety or well-being of any
coach, parent, player, participant, official or any other attendee.
I will not use drugs or alcohol while at a youth sports event and will not
attend, coach, officiate or participate in a youth sports event while
under the influence of drugs or alcohol.
I will not permit my child, or encourage any other person, to use drugs
or alcohol at a youth sports event and will not permit my child, or
encourage any other person, to attend, coach, officiate or participate in
a youth sports event while under the influence of drugs or alcohol.
I will not engage in the use of profanity.
I will not encourage my child, or any other person, to engage in the use
of profanity.
I will treat any coach, parent, player, participant, official or any other
attendee with respect regardless of race, creed, color, national origin,
sex, sexual orientation or ability.
I will encourage my child to treat any coach, parent, player, participant,
official or any other attendee with respect regardless of race, creed,
color, national origin, sex, sexual orientation or ability.
I will not engage in verbal or physical threats or abuse aimed at any
coach, parent, player, participant, official or any other attendee.
I will not encourage my child, or any other person, to engage in verbal
or physical threats or abuse aimed at any coach, parent, player, participant, official or any other attendee.
I will not initiate a fight or scuffle with any coach, parent, player,
participant, official of any other attendee.
I will not encourage my child, or any other person, to initiate a fight or
scuffle with any coach, parent, player, participant, official or any other
attendee.
I will abide by any decision rendered by the Code of Conduct Committee or the Township Parks and Recreation Commission.
I will be responsible for the behavior of all those attending a Township
youth sports event on my child’s behalf.
The participants, parents or legal guardians of minor participants, coaches and
officials of every sports organization shall be required to follow the Code of
Conduct, set forth as follows:
I hereby pledge to be responsible for my words and actions while attending, coaching or participating in a Township sports event and shall conform my behavior to
the following code of conduct:
CODE OF CONDUCT

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