Windsor Aquatic Club - Permission Form

 

Meet:

Wallaceburg Marlin S.E.A.L. Swim Meet
Hosted By:
 Wallaceburg Marlins
Location:
 Wallaceburg Sydenham Pool, Lorne Ave & Wall St.
519-627-1606
Date:
 Sunday November 19th, 2006
Session Times:
 Warm-ups 8:00 a.m.
Start 8:45 a.m.
Cost:
 $25.00
per event
x _ _ _ _ _ events =
 $ _ _ _ _ _ _
Team Surcharge
 $ _ _ _ _ _ _
Total

$ _ _ _ _ _ _
     
 

Return completed permission form to COACH with payment attached
 
NO LATER THAN -
Saturday November 4th, 2006

- NO EXCEPTIONS
 

Name:

_______________________________________________
 
S.E.A.L. Wallaceburg – November 19th, 2006
   
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:______________