2014 AREA XII JR. HIGH CHAMPIONSHIPS
TUNKHANNOCK HIGH SCHOOL
135 Tiger Drive
Tunkhannock , PA 18657
DATE: Sunday, February 16th, 2014
Weigh-Ins: Sunday - 2/16/2014 from 7 AM to 8:30 AM Tunkhannock High School
Wrestling Start Time: 10:00 AM
Tournament Director Area XII Alternate Chairman: Tom Traver – 570-239-4934 e-mail:
Area XII Chairman: Gary Siegel - 570-574-5678 e-mail:
Registration: On line at http://wrestlereg.com – Deadline for online entry is Thursday, February 13th.
Mail entry form to Tom Traver – 1122 Monkey Hollow Road, Monroe Twp., Pa 18618
Mail in forms must be postmarked no later than Monday, February 10th
PRE-REGISTRATION ONLY ** NO WALK IN REGISTRATIONS ACCEPTED
Web Sites for Additional information: PJW AREA XII | WVCD2.COM, www.rakinfo.com/pennleague, www.pywrestling.com, www.pajw.org
Entry Fee: Mail in / $25.00 Make Check payable to PJW AREA XII, On-line wrestlereg / $27.00
Admission: Adults - $7.00 Students - $4.00 Hot food and drinks available.
Awards will be awarded to 1st – 2nd – 3rd Place Finishers
1st and 2nd Place Advances to the JR. HIGH State Championship, March 1st & 2nd to be held at Hempfield High School Fieldhouse, Greensburg, PA.
PJW RULES
1) Wrestler must reside in one of the following counties
: Bradford, Lackawanna, Luzerne, Pike, Susquehanna, Wayne and Wyoming.
2) Wrestler may only submit 1 Entry Form.
3) Wrestlers in grade 7th, 8th and 9th with PIAA defined Jr. 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 weight changes permitted after entry form has been submitted.
8) Wrestlers not making weight at weigh in will forfeit their entry without refund.
9) Birth Certificate and proof of residency of both wrestlers must be provided if challenged.
10) All entrants must be willing to represent Area XII at the PJW Jr. High State Finals in Greensburg.
11) Advancing wrestlers must complete advancement process prior to leaving the tournament.
12) Advancing wrestlers will be required to pay a refundable $70.00 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) Suitable undergarment must be worn for weigh in.
16) Head gear is required, shoe laces must be secured, PIAA hair rule applies, and mouth guard is required to cover braces.
17) Seeding will be determined by tournament committee and information provided.
18) Full double elimination format with wrestle back for true second.
19) Application must be completed in its entirety.
21) Release and Waiver of Liability Agreement & Participant Code of Conduct form must be completed and brought along to weigh in or mailed with entry form.
22) Failure to comply with any PJW or PIAA rule will result in disciplinary action and/or forfeiture of participation.
2014 AREA XII Jr. High CHAMPIONSHIPS
TUNKHANNOCK HIGH SCHOOL
135 Tiger Drive
Tunkhannock , PA 18657
ENTRY FORM
Name: ______Phone Contact # (___) _____- ______
Full Address:
Street ______City:______Zip: ______
e-mail: ______Age______
School District: (no clubs) ______
County of Residence: ______Birth Date: ______
***Please circle the Weight class you are entering. ***
Jr. High:
77, 82, 87, 92, 97, 102, 107, 112, 117, 124, 132,
140, 147, 157, 167, 187, 212, 252 maximum
This year (2013-2014) Record: Wins: ______Losses: ______
HONORS: ______
______
Last year (2012-2013) Record: Wins: ______Losses: ______
HONORS: ______
______
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 2014 PJW Events.
Wrestlers Signature ______Date:______
Parent, Guardian or Coaches Name: ______
Parent, Guardian or Coaches Signature: ______Date:______
Application MUST be COMPLETE and SIGNED. This form may be duplicated
THIS PAGE MUST BE COMPLETED AND BROUGHT TO WEIGH IN OR MAILED WITH ENTRY FORM.
RELEASE AND WAIVER OF LIABILITY AGREEMENT & PARTICIPANT CODE OF
CONDUCT
I,______, acknowledge that I have voluntarily applied to participate in the
(Entrants full name)
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.
I verify this statement by placing my initials here: ______Parent or Guardian’s initials: ______
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.
While participating in PJW activities, the Participant will be supervised by ______.
(Coach or Parent’s name)
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.
______
Parent/ Guardian Signature Date Signed
______
Contestant Signature Date Signed
THIS PAGE MUST BE COMPLETED AND BROUGHT TO WEIGH IN OR MAILED WITH ENTRY FORM.
PJW AREA XII