NEW ENGLAND BRONZE CLASSIC

NEW ENGLAND BRONZE CLASSIC

WHITE BROOK MIDDLE SCHOOL

FEBRUARY 8-10, 2002

TEAM NAME________________________________________________________

TEAM ABBREVIATON_________________

ADDRESS____________________________________________________________

____________________________________________________________

COACH________________________________ PHONE_______________________

CONTACT PERSON______________________ PHONE______________________

ENTRY FEES

ELECTRONIC ENTRIES:

________ FEMALE EVENTS AT $3.00 _______________

________ MALE EVENTS AT $3.00 _______________

________ FEMALE DISTANCE EVENTS AT $5.00 _______________

________ MALE DISTANCE EVENTS AT $5.00 ______________

TOTAL AMOUNT OF CHECK ________________

HAND ENTRIES:

_________ FEMALE EVENTS AT $3.50 _______________

_________ MALE EVENTS AT $3.50 _______________

_________ FEMALE DISTANCE EVENTS AT $5.50 _______________

_________ MALE DISTANCE EVENTS AT $5.50 ______________

TOTAL AMOUNT OF CHECK ________________

PLEASE MAKE CHECKS PAYABLE TO "EASTHAMPTON BARRACUDAS SWIM TEAM".

MAIL TO: Cheryl Fletcher

22 Gunn Rd.

Southampton, MA 01073

E-MAIL Fletchcows@aol.com

NEW ENGLAND SWIMMING TRAVEL FUND SURCHARGE. ENCLOSE SEPARATE CHECK PAYABLE TO "NES":

#_________INDIVIDUALS ENTERED IN THE MEET AT $1.00 =_____________

ALL ENTRIES AND CHECKS MUST BE RECEIVED BY 5:00 PM, JANUARY 28, 2002.

ANY SWIMMER WHOSE ENTRY IS ACCEPTED WILL, FOR HIMSELF, HIS HEIRS,EXECUTORS,AND ADMINISTRATORS, WAIVE AND RELEASE ANY AND ALL RIGHTS AND CLAIMS FOR DAMAGES HE MAY HAVE AGAINST UNITED STATES SWIMMING, NEW ENGLAND SWIMMING, EASTHAMPTON BARRACUDAS SWIM TEAM, AND WHITE BROOK MIDDLE SCHOOL FOR ANY AND ALL INJURIES SUFFERED BY HIM AT SAID SWIM MEET.

CLUB OFFICIAL OR COACH _________________________________

NAMES OF CERTIFIED OFFICIALS WISHING TO HELP:

__________________________________________PHONE___________________