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NO REFUNDS

WWW.PJWAREAIX.COM
TRAVIS GARDNER ~ CHAIRMAN
JAMES SCHWALM ~ ALTERNATE

2016 AREA IX ~ JR. HIGH CHAMPIONSHIPS
Earn the Title:
PENNSYLVANIA JUNIOR HIGH STATE CHAMPION
www.pajw.org

CUMBERLAND VALLEY HIGH SCHOOL
6746 CARLISLE PIKE
MECHANICSBURG, PA 17050

DATE: Sunday, February 21, 2016
Weigh~In Time: 8:00 ~ 9:00 AM
Wrestling Start Time: 10:00 AM
Tournament Director: Jerry Lucas    Phone: 717~554~4743    E~mail: biteck@comcast.net
Registration: On line at http://wrestlereg.com ~ Deadline for online entry is Friday, February 19, 2016 at 5:00 pm

PRE~REGISTRATION ONLY   **   NO WALK IN REGISTRATIONS ACCEPTED

Entry Fee: $25.00
Admission: Adults ~ $6.00    Students ~ $4.00
Awards will be awarded to 1st ~ 2nd ~ 3rd Place Finishers    
1st, 2nd and 3rd Place Finisher advances to the Jr. High State Championship on Saturday, March 5th & Sunday, March 6th at War Memorial Arena, in Johnstown, Pa.

PJW RULES
1)    Wrestler must reside in one of the following counties; Adams, Cumberland, Franklin, Perry, York.
2)    Wrestler may only submit 1 Entry Form.
3)    Wrestlers in grade 7, 8, and 9 with PIAA defined Junior High eligibility may participate.
4)    No wrestler with PIAA defined Varsity or Jr. Varsity experience will be permitted.
5)    An 11 and 12 year old on a Jr. High roster may choose only 1 PJW tournament series (Youth or Jr. High).
6)    Refer to http://www.piaa.org/schools/eligibility/default.aspx for PIAA defined eligibility..
7)    No school issued uniforms or singlets are permitted.
8)    No weight changes permitted after entry form has been submitted.
9)    Wrestlers not making weight at weigh in will forfeit their entry without refund.
10)    Birth Certificate and proof of residency of wrestlers must be provided if challenged.
11)    Advancing wrestlers must complete advancement process prior to leaving the tournament.
12)    Advancing wrestlers will be required to pay a refundable $75.00 deposit for singlet use prior to leaving tournament.
13)    Advancing wrestlers MUST provide a copy of Birth Certificate prior to leaving tournament.
14)    All Bout times are 1:30 ~ 1:30 ~ 1:30.  PIAA Overtime rules will apply.
15)    Head gear is required, shoe laces must be secured, PIAA hair rule applies, and mouth guard is required to cover braces.
16)    Seeding will be by records provided on entry form.
17)    Full double elimination format with wrestle back for true second.  * Weight classes with 6 or fewer participants will utilize round~robin format.
18)    Application must be completed in its entirety.
19)    Release and Waiver of Liability Agreement & Participant Code of Conduct form must be completed and brought along to weigh in.
20)    Failure to comply with any PJW or PIAA rule will result in disciplinary action and/or forfeiture of participation.
21)    Jr. High Weight Classes:  77, 82, 87, 92, 97, 102, 107, 112, 117, 124, 132, 140, 147, 157, 167, 187, 212, 252 maximum


I hereby state that all information provide on this entry form is correct and I understand that by falsifying any information will result in forfeiture of my entry. I agree to abide by all PJW and PIAA rules while participating in the 2016 PJW Events.


RELEASE AND WAIVER OF LIABILITY AGREEMENT & PARTICIPANT CODE OF CONDUCT
I acknowledge that I have voluntarily applied to participate in the Pennsylvania Junior Wrestling (PJW) Tournament.   I am aware that these activities may be hazardous and that I could be seriously injured.  I am voluntarily participating with knowledge of the danger involved, and agree to assume any and all risks of bodily injury, or death, whether those risks are known or unknown.
As consideration for being permitted by PJW, and any owner, administrator, tournament director, chairperson of the premises holding any of the events, to participate in these activities and use the premises and facilities,  I forever release PJW or any Lessor or any PJW affiliated organization, and their respective directors, officers, employees, volunteers, agents, contractors,  and representatives (collectively 'Releasees') from any and all actions, claims, or demands that I, my assignees, heirs, distributees, guardians, next of kin, spouse and legal representatives now have, or may have in the future, for injury, death, or property damage, related to (i) my participation in these activities, (ii) the negligence or other acts, whether directly connected to these activities or not, and however caused, by any Releasee, or(iii) the condition of the premises where  these activities occur, whether or not I am then participating in the activities.   I also agree that I, my assignees, heirs, distributees, guardians, next of kin, spouse and legal representatives will not make a claim against, sue, or attach the property of any Releasee in connection with any of the matters covered by the foregoing release.
I have carefully read this agreement and fully understand its contents.  I am aware this is a release of liability and a contract between myself and PJW, and the lessors, and sign it of my own free will.  When Signed by Parent or Guardian: I recognize the dangers of the activities and the significance of this Release and Waiver were explained to the Participant and that the Participant understood them, or I, as parent of the Participant, understand them.

I understand the Tournament Director, under the guidance of the PJW rules and administration, may withdraw our son/daughter from any Tournament if he/she is involved in behavior or activity deemed to be detrimental to the health, safety or welfare of other participants, spectators, tournament staff, or tournament sites; or if involved in actions considered to be detrimental to the goals and objectives of PJW or in violation of the PJW Code of Conduct.  We have read and agree with the tournament rules as listed on the information page.