Strath Haven Panthers: Welcome

Wednesday, August 24
Team Photo 
SEPA WRESTLINGFall Session 2011Scholastic WrestlingPlease visit our website at SEPAwrestling.comEmail us at 3 GREAT CLUBS FOR THE PRICE OF 1 SEPA Bucks                                                                                         SEPA South       

                 All registration forms are to be given to Tara Jordan   All Registration forms are to be given to Kelli Barlow

 Tuesdays and Thursdays (September 6 – November 3)              Tuesday and Thursday (September 6 – November 3)

                 Elem. 6:00 – 7:30pm                                                                             Elem. 6:00 – 7:30pm

                 Middle School and High School 7:30 – 9:00pm                              Middle School and High School 7:30- 9:00pm


                 Carl Sandburg MS                                                                              The Haverford School                                                                        

 30 Harmony Ln                                                                                    450 Lancaster Ave.

 Levittown, PA 19046                                                                          Haverford, PA 19041

 Make checks payable to: SEPA Wrestling                                     Make checks payable to: SEPA South

Mail to: SEPA Bucks

                PO Box 7138

                Penndel, PA 19047                                                                              

 SEPA North

All registration forms are to be given to Rollie Stillings

Mondays and Wednesdays (September 7 –November 2)

                Elem. and Middle School 6:00 – 7:30pm

                High School 7:30 – 9:00pm


Sports Performance Ctr.

110 Christopher Ln.

Harleysville, PA 19438

 Make checks payable to: SEPA Wrestling NorthMail to: SEPA North                PO Box 936

                Trumbauersville, PA 18970

    KURT PAROLY (All 3 locations) – 215-595-4526 JOE ERB (All 3 locations) – 267-907-4807

ROLLIE STILLINGS (SEPA North) – 215-260-6380

KELLY BARLOW (SEPA South) – 610-733-5980

SEPA REGISTRATION FALL 2011(SEPA Bucks ____ SEPA North ____ SEPA South___)WRESTLER’S NAME: _____________________________________________________________  MOTHER’S NAME: _______________________ FATHER’S NAME: ________________________ MOTHER’S CELL #: _______________________ FATHER’S CELL #: _______________________ HOME NUMBER: __________________________ DOB: __________________ AGE: ____________ ADDRESS: _______________________________________________________________________  CITY ________________________________ STATE_________________ ZIP_________________ E-MAIL:__________________________________________________________________________ SCHOOL: __________________________GRADE:________ NO. OF YRS WRESTLING: ________  INSURANCE PROVIDER: ___________________________________________________________ REGISTRATION ***All clothing orders must be placed by September 15th ***             Package 1: $100                        T-SHIRT: SIZE (YM, YL, AS, AM, AL, AXL, AXXL)                        SHORTS: SIZE (YS, YM, YL, AS, AM, AL, AXL, AXXL)                        AAU CARD              Package 2: $75                        AAU CARD 


SWEATSHIRTS (YM, YL, AS, AM, AL, AXL, AXXL)            __________@ $30/ea        ____________      T-SHIRT (YM, YL, AS, AM, AL, AXL, AXXL)                    __________ @ $15/ea         ____________SHORTS (YS, YM, YL, AS, AM, AL, AXL, AXXL)             __________ @ $20/ea         ____________REGISTRATION                                                                                                                 $75 or $100                                                                                                                         TOTAL          ____________   I, THE  PARENT OF THE ABOVE CHILD, HEREBY GIVE MY PERMISSION TO PARTICIPATE IN ANY AND ALL WRESTLING ACTIVITIES DURING THE CURRENT SPORT SEASON. I ASSUME ALL RISKS AND HAZARDS INCIDENTAL TO SUCH PARTICIPATION INCLUDING TRANSPORTATION TO AND FROM ACTIVITIES AND DO HEREBY WAVE, RELEASE, ABSOLVE, INDEMNIFY AND AGREE TO HOLD HARMLESS SOUTHEAST PA WRESTLING, THE ORGANIZER, SPONSORS, SUPERVISORS, PARTICIPANTS AND PARENTS TRANSPORTING MY CHILD TO AND FROM ACTIVITIES, FOR ANY CLAIM ARISING FROM INJURY TO MY CHILD EXCEPT TO THE EXTENT AND IN THE AMOUNT OF THE SOUTHEAST PA WRESTLING’S ACCIDENT OR LIABILITY INSURANCE, PROVIDED SUCH CLAIMS ARE NOT COVERED BY MY PRIVATE MEDICAL PLAN.  PARENT/GUARDIAN SIGNATURE: _______________________________ DATE: ___________________  ---------------------------------------------------------------OFFICIAL USE---------------------------------------------------------TOTAL OWED____________________ METHOD OF PAYMENT          CASH_______________      CHECK #________________ BALANCE OWED____________________                               SEPA BUCKS _________       SEPA North ________  SEPA South _______ SOUTHEAST PA WRESTLING RULES ACKNOWLEDGE FORMPARENTAL FORM CHILD’S NAME ______________________________  I UNDERSTAND THAT THE HEAD COACH IS RESPONSIBLE FOR THE ACTIONS OF ALL THE YOUTH PARTICIPANTS, COACHING STAFF AND PARENTS THAT ARE INVOLVED IN THE EVENTS FOR THE TEAM IN WHICH MY CHILD PARTICIPATES. I ACKNOWLEDGE THAT I HAVE READ AND UNDERSTAND THE PARTICIPANT CODE OF CONDUCT.  I UNDERSTAND THAT ANY VIOLATION OF THESE RULES IS SUBJECT TO DISCIPLINARY ACTION BY SEPA WRESTLING.  I UNDERSTAND THAT IT IS MY RESPONSIBILTY AS A PARENT/GUARDIAN OF THE ABOVE NAMED CHILD, TO ADVISE ANY INDIVIDUAL(S) WHO I INVITE OR BRING TO A TEAM EVENT OF ALL RULES AND REGULATIONS. I UNDERSTAND THAT I WILL BE HELD ACCOUNTABLE FOR THEIR CONDUCT, WHILE IN ATTENDANCE AT A TEAM EVENT. NO PARENT WILL BE ALLOWED INTO THE WRESTLING PRACTICE ROOM AT ANY TIME DURING THE SEASON.  I HEREBY UNDERSTAND THAT DISCIPLINARY ACTION OF A WARNING, WRITTEN REPRIMAND, OR A SUSPENSION WILL NOT BE SUBJECT TO AN APPEAL. MY SIGNATURE BELOW WILL CONFIRM THAT I UNDERSTAND AND ACCEPT THE ABOVE AS CONDITIONS TO MY CHILD’S PARTICIPANT FOR SOUTHEAST PA WRESTLING.  ______________________________________ ________ _______________________________ ________ PARENT OF GUARDIAN DATE PARENT OR GUARDIAN                                                          DATE  ______________________________________ ________ _______________________________ ________ ADDITIONAL PARENT DATE ADDITIONAL PARENT                                                               DATE  EACH PARENT/GUARDIAN MUST SIGN THIS FORM. FORM IS TO BE TURNED INTO THE PRESIDENT. A NEW FORM IS TO BE COMPLETED WHEN ADDITIONAL OR DELETIONS ARE MADE. SOUTHEAST PA WRESTLING FALL SPONSORSHIP FORM  Save on registration by getting Corporate Sponsors.  For each $100 sponsorship you get, we will refund you $50 (up to 2 sponsors). All Sponsorship forms need to be in by September 15th, in order to have name put on back of T-shirts. For sponsoring our team, your sponsor will receive:  COMPANY NAME ON BACK OF T-SHIRT   LINK FROM OUR WEB PAGE  ( MAKE CHECKS PAYABLE TO: SEPA WRESTLING or SEPA Wrestling NorthTHANK YOU FOR YOUR SUPPORT -----------------------------------------------------------------------------------------------------------------------------------  COMPANY NAME: _______________________________________  CONTACT NAME: ________________________________________  PHONE NUMBER: ________________________________________  WEB LINK or EMAIL: __________________________________________________________  BRIEF DESCRIPTION OF COMPANY ____________________________________________ _____________________________________________________________________________

 WRESTLER’S NAME WHO RECEIVED SPONSOR: _________________________________