PERMISSION FOR MEDICAL TREATMENT, RELEASE OF MEDICAL INFORMATION AND PAYMENT OF MEDICAL EXPENSE I REQUEST AND GIVE PERMISSION to the physicians and medical staffs to treat the above-named participant appropriately, including hospitalization, prescribing medication, and performing emergency medical procedures. I AUTHORIZE release of any medical information to a doctor 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 which is:
Name and Phone Number of Individual(s) to Contact in Case of Emergency Waiver: My son/daughter has been examined by a physician in the last year and is in good health. I hereby authorize Minnesota Storm coaches to act for me, according to its best judgment in any medical emergency, and I hereby waive and release said camp from any liability for injuries or illness incurred by my son/daughter while attending camp.
NOTE!!! The Minnesota Training Center/Minnesota Storm does NOT carry group medical coverage for this program.
Please make checks payable to: Minnesota Training Center
Send application and deposit to:
Minnesota Training Center
2211 Riverside Ave
Campus box 313
Minneapolis, MN 55454
For additional information contact Brian Graham (816) 392-4954, Mike Tschida (763) 496-7706 or email us directly at email@example.com.
Let us know! (We may send you cool things.)
GopherWC bringing home some hardware from the Cerro Pelado over the weekend:
Hayden Zillmer 🥉
Brett Pfarr 🥉
Nazar K… https://t.co/8a7g8boJyt
Tue, Feb 18th, 2020 5:23pm
RT @USAWrestling: Check out @MarkSBader's sit-down with @DustinSchlatter
Thu, Feb 13th, 2020 12:20am
RT @MinnesotaOnBTN: Down late? No problem for No. 4 Brayton Lee.
He takes his momentum to sudden victory and ends the match quickly, closi…
Sat, Feb 1st, 2020 2:52pm
Brett Pfarr finishes 2-2 @ the XXXI Grand Prix -Ivan Yariguin in Krasnoyarsk, Russia #GopherWC #MnStorm https://t.co/fEz5w7D6hW
Sun, Jan 26th, 2020 10:30pm
RT @DustinSchlatter: Brett Pfarr gets the opening round tech 12-2 over Mongolia. Falls to ‘19 world bronze Naifonov (RUS) 0-6. Pfarr is pul…
Sat, Jan 25th, 2020 10:44pm
RT @DustinSchlatter: Gopher wrestling club with 5 placers, 2 finalist and a champ at the US open. Zillmer, Nelson, Pfarr and Sanders all qu…
Mon, Dec 28th, 2020 2:30am
RT @DustinSchlatter: 2019 US Open Champion Hayden Zillmer https://t.co/es6X4cltWG
RT @DustinSchlatter: Proud of the way all ten of our athletes competed this weekend at the #billfarrell. The #GopherWC led the field with 4…
Tue, Nov 24th, 2020 12:09am
RT @FloWrestling: Check out the reactions for the Bill Farrell Brackets which are in FloArena! https://t.co/hLcGxcW3cx
Sat, Nov 21st, 2020 3:39pm
RT @FloWrestling: Mens Freestyle at the Bill Farrell Memorial International Open starts NOW on FloWrestling! https://t.co/kITeeab65Y
RT @DustinSchlatter: The first Olympic trials qualifying event starts today in New York City at the Bill Farrell. The GopherWC will be well…
Sat, Nov 21st, 2020 3:38pm
Big thanks to United States National Greco Roman Head Coach @mattlindland for working with the Greco team the last… https://t.co/vYQpxw2pVW
Fri, Nov 20th, 2020 2:34am
RT @FloWrestling: The start of the Minnesota Wrestling dynasty.
Tue, Nov 3rd, 2020 11:40pm
Chad Gable!!! https://t.co/YLCFTuLfHJ
Sat, Oct 17th, 2020 4:21am
RT @GopherWrestling: Great work by volunteer coach Zach Sanders and @MTCStorm athlete Hayden Zillmer for advancing to the semifinals out in…
Sat, Oct 17th, 2020 12:36am
RT @DustinSchlatter: Sanders and Zillmer to the semis in Dagestan
Fri, Oct 16th, 2020 1:39pm
RT @DustinSchlatter: Wrestling begins at the continental cup 11am tomorrow (3am cst) first round draws for storm athletes:
Sanders vs Badr…
Thu, Oct 15th, 2020 6:20pm
RT @DustinSchlatter: Team USA getting acclimated in Dagestan https://t.co/NgSKt4GzTK
RT @GopherWrestling: Join the #Gophers on October 26 for our FREE kids clinic directly before our open practice and wrestle-offs!
Wed, Oct 14th, 2020 12:42pm
RTC practices held at the university of Minnesota’s Bierman field athletic building will take place- Monday, Tuesda… https://t.co/YRBcnWL6Zp
Tue, Sep 8th, 2020 6:52pm
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