Windsor Aquatic Club - Permission Form

 

Meet:

2007 Ontario Senior Provincials
Hosted By:
 Toronto Swim Club and Mississauga Swimming
Location:
 University of Toronto
Date:
 January 12-14, 2007
Session Times:
 See www.torontoswimclub.bigstep.com "Hosted Meets"
Cost:
 $6.42
per event
x _ _ _ _ _ events =
 $ _ _ _ _ _ _
Team Surcharge
 $350.00 _ _ _ _ _ _
Total

$ _ _ _ _ _ _
     
 

Return completed permission form to COACH with payment attached
 
NO LATER THAN -
Saturday December 23, 2006

- NO EXCEPTIONS
 

Name:

_______________________________________________
 
Ontario Senior Provincials - University of Toronto
   
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:______________