Windsor Aquatic Club - Permission Form

 

Meet:

Wallaceburg Marlins Seal Meet #1

Hosted By:
Wallaceburg Marlins Swim Club
Location:
920 Elgin St. Wallaceburg Ontario
Date:
Sunday October 21st, 2007
Session Times:
Warm-ups: 8:15a.m.
Start Times:  9:00a.m

Cost:
$00.00
per event
x _ _ _ _ _ events =
$12.00 _ _ _ _ _ _
Team Surcharge
$18.00 _ _ _ _ _ _
Total

$30.00 _ _ _ _ _

     
 

Return completed permission form to COACH with payment attached

 
NO LATER THAN -
October 10th, 2007

- NO EXCEPTIONS

 

Name:

_______________________________________________

 
S.E.A.L.#1 Wallaceburg - Wednesday, October 21, 2007
   
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:______________