World of Wrestling - Roller Productions
Shane Roller's 2008 All-Star Camp Application
- Roller's 2009-10 All-Star Clinic Application -
Thanks for your interest in our wrestling clinics!
* Indicates Required Fields
| *Camper Name | *Address | |||
| *City | *State | |||
| *Zip Code | ||||
| *Parent/Guardian Name | ||||
| (first) | (last) | |||
| *Home Telephone | *Work | |||
| (format) | 111 111-1111 | 111 111-1111 | ||
| *School Attending | ||||
| *Age | *Weight | |||
*Please charge a deposit of : $ You must pay the the full amount of $. A balance of $ is Due upon arrival to the Clinic. Please note that your payment is NON-REFUNDABLE. |
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PERMISSION FOR MEDICAL TREATMENT, RELEASE OF MEDICAL INFORMATION AND PAYMENT OF MEDICAL EXPENSE: I REQUEST AND GIVE PERMISSION to physicians and medical staff to treat the above-named participant appropriately, including hospitalization, prescribing medication, and performing emergency medical procedures. I AUTHORIZE release of any medical information to the medical centers which may be pertinent to any diagnosis or treatment of the above-named participant. I UNDERSTAND that any charges resulting from this medical treatment will be billed to me at my address or to my medical insurance carrier. Waiver: My son/daughter has been examined by a physician in the last year and is in good health. I hereby authorize the Roller All Star Clinic Staff to act for me, according to its best judgement in any medical emergency, and I hereby waive and release said clinic from any liability for injuries or illness incurred by my son/daughter while attending the clinic. |
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*I agree to the terms listed above |
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Upcoming Tournaments
We have several upcoming tournaments for the 2009-2010 season. Please click the "View All" button below for a listing of tournaments and registration information.
Recent Updates
New Locations
Two new locations are open for a World of Wrestling Tournament! If you or your team are interested in helping in your area, contact your local Convention & Visitors Bureau or Sports Commission and have them give Jack Roller a call at 918-366-4411.
Our Sponsors
Testimonials
I would like to thank World of Wrestling for helping to prepare my son for high school wrestling. My son will be competing in his 7th Reno Worlds tournament this April. He has placed the last four years in two different age divisions. This year he placed 5th at the California High School State Wrestling Championships as a sophomore. The proud moment he experienced on the medals podium was similar to his first medal at Reno Worlds. Raging Elks Wrestling
martin ramirez