Windsor Aquatic Club - Permission Form
Meet:
Hosted By:
Location:
11091 West 32-Mile Romeo,
Michigan.
Date:
Session Times:
Cost:
per event
x _ _ _ _ _ events
=
Team Surcharge
Total
$ _ _ _ _ _ _
Windsor Aquatic Club - Permission Form
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Meet: |
Romeo & Juliet | |||
Hosted By: |
Romeo Dolphins Swim Club (RDSC) | |||
Location: |
Romeo
Senior High School, 11091 West 32-Mile Romeo, Michigan. |
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Date: |
February 15 - 17, 2008 | |||
Session Times: |
www.uss-michigan.com under "2008 Meet Info" | |||
Cost: |
$4.25 | per event |
x _ _ _ _ _ events
= |
$ _ _ _ _ _ _ |
Team Surcharge |
$30.00 _ _ _ _ _ _ | |||
Total |
$ _ _ _ _ _ _ |
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Return completed permission form to COACH with payment attached |
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NO LATER THAN - |
Wednesday,
February 6, 2008
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- NO EXCEPTIONS |
Name: |
_______________________________________________ |
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Romeo &
Juliet - February 15 - 17, 2008
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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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