University of Connecticut, Storrs, Connecticut
June 20-22, 2003
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 @ $3.00 each $___________
_____ Distance events (800 and 1500 meters) @ $5.00 each $___________
TOTAL $___________
Make check payable to: Shawmut Aquatic Club
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MAIL ENTRIES & CHECKS TO: SHAWMUT AQUATIC CLUB |
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C/O Carrie Thompson |
|
86 Beechwood Road |
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Wellesley, MA 02482 |
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Phone: (781) 235-3150 |
ENTRY DEADLINE: Entries must be received by June 8, 2003 at 5:00 PM.
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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.
____/____/03 ________________________________________
Date Signature of Authorized team Official