SHAWMUT AQUATIC CLUB’S SUMMER SOLSTICE CLASSIC

University of Connecticut, Storrs, Connecticut

June 18-20, 2004
 

TEAM NAME:  __________________________________  ABBR.: ________________

COACH:            _________________________________  PHONE: _______________

Name and address of the person to receive all communication including meet results, timing assignments, warm-up changes and questions about entries:

Name:          _____________________________________________________

Address:      _____________________________________________________

City/Town:  _____________________  State: ______  Zip: _________ FAX:____________

Day:____________   Evening:_________

email:___________________________________

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ENTRY FEES

_____ Individual Events @ $3.50 each                                                                  $___________

_____ Distance events (800 and 1500 meters) @ $5.00  each                                  $___________

                                                                                                        TOTAL   $___________

 Make check payable to: Shawmut Aquatic Club

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ENTRY DEADLINE:  Entries must be received by June 9, 2004 at 5:00 PM.

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LIABILITY RELEASE

Any swimmer whose entry is accepted will, for him/herself, his/her heirs, executors, and administrations, waive and release any and all rights and claims for damages he/she may have against United States Swimming, New England Swimming, Connecticut Swimming, Shawmut Aquatic Club, and the University of Connecticut for any and all injuries suffered by him/her at said meet.

____/____/04                                      ________________________________________

  Date                                                             Signature of Authorized team Official