Windsor Aquatic Club - Permission Form
Meet:
Hosted By:
Location:
Date:
Session Times:
Cost:
per event
x _ _ _ _ _ events
=
Team Surcharge
Total
$ _ _ _ _ _ _
Windsor Aquatic Club - Permission Form
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Meet: |
2008
Short Course Western Ontario Regional Championships
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Hosted By: |
Brantford
Aquatic Club |
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Location: |
Wayne Gretzky Sports Centre | |||
Date: |
February 1 - 3, 2008 | |||
Session Times: |
www.brantfordaquaticclub.ca | |||
Cost: |
$6.00 | per event |
x _ _ _ _ _ events
= |
$ _ _ _ _ _ _ |
Team Surcharge |
$200.00_ _ _ _ _ _ | |||
Total |
$ _ _ _ _ _ _ |
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Return completed permission form to COACH with payment attached |
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NO LATER THAN - |
Thursday,
January 17, 2008
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- NO EXCEPTIONS |
Name: |
_______________________________________________ |
|
|
2008
Short Course Western Ontario Regional Championships
February 1 - 3, 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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