Windsor Aquatic Club - Permission Form
Meet:
The 2007 Eric Namesnik Memorial Grand Prix
Hosted By:
Location:
500 East Hoover Street, Ann Arbor, Mi.
Date:
Session Times:
Cost:
per event
x _ _ _ _ _ events
=
Team Surcharge
Total
$ _ _ _ _ _ _
Windsor Aquatic Club - Permission Form
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Meet: |
The 2007 Eric Namesnik Memorial Grand Prix |
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Hosted By: |
The University of Michigan and Club Wolverine | |||
Location: |
Canham
Natatorium, U of M, 500 East Hoover Street, Ann Arbor, Mi. |
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Date: |
May 17-20, 2007 | |||
Session Times: |
www.usaswimming.org | |||
Cost: |
$12.00 | per event |
x _ _ _ _ _ events
= |
$ _ _ _ _ _ _ |
Team Surcharge |
$85.00 _ _ _ | |||
Total |
$ _ _ _ _ _ _ |
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Return completed permission form to COACH with payment attached |
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NO LATER THAN - |
Monday,
April 9, 2007
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- NO EXCEPTIONS |
Name: |
_______________________________________________ |
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The
2007 Eric Namesnik Memorial Grand Prix
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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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