Windsor Aquatic Club - Permission Form
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Meet: |
Holiday Splash |
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Hosted By: |
Leroy Dues Swim Club | |||
Location: |
Wayne State University | |||
Date: |
December 16 & 17, 2006 | |||
Session Times: |
Saturday,
December 16 Warm-up 7:30 a.m. Start 8:30 a.m. Saturday, December 16 Warm-up 12:30 p.m. Start 1:30 p.m. Sunday, December 17 Warm-up 7:30 a.m. Start 8:30 a.m. Sunday, December 17 Warm-up 12:30 p.m. Start 1:30 p.m. |
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Cost: |
$5.00 | per event |
x _ _ _ _ _ events
= |
$ _ _ _ _ _ _ |
Team Surcharge |
$35.00 _ _ _ _ _ _ | |||
Total |
$ _ _ _ _ _ _ |
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 |
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Return completed permission form to COACH with payment attached |
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NO LATER THAN - |
Saturday, December 2, 2006
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- NO EXCEPTIONS |
Name: |
_______________________________________________ |
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Holiday
Splash - Leroy Dues Swim Club - Dec 16-17 2006
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Payment enclosed: |
$____________________ | |
| I am a parent (guardian) of the above child, and in consideration of the Windsor Aquatic Club permitting my child to take part in the aforementioned swim meet, I hereby agree that the Windsor Aquatic Club, its officers, directors, coaches and members shall not, except for negligence, be responsible for any injury, loss, damages or costs which may be suffered or incurred by me or my said child arising out of the said meet, including, but not limited to transportation to and from the meet, accommodation at the meet, and incidental activities while attending the meet. PARTIAL REFUNDS ON TRAVEL AND ACCOMMODATION FEES FOR MEDICAL REASONS ONLY. | ||
| SIGNATURE:___________________________________ DATE:______________ |
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