The Cape Cod Swim Club
January 11-13, 2001    Sanction # NE-01-65
SUMMARY SHEET

Name of Team:________________________________________   Code Letters:__________
Team Mailing Address:________________________________________________________

Coach:________________________________________________ 
Phone:__________________________  Email: ___________________________

Contact Person:_____________________________________________ 
Phone:__________________________  Email: ___________________________

Number of Entries:   

            Computer Entries (add $0.50 per splash for paper entries):

                        Girls                _____  x $2.50 = __________

                        Boys                 _____ x $2.50 = __________          

                        Distance          _____  x $4.00 = __________    *400 yards and over

                        Relays              _____  x $7.00 = __________

   TOTAL  __________

             Entry Deadline:  December 30, 2001

Please make checks payable to: Friends of the CCSC

Mailing Address:   P.O. Box 966 (14 Ellen Lane), Pocasset, MA  02559-0966

Any swimmer whose entry is accepted, will for himself, his heirs or executors and administrators, waive and release any and all rights and claims for damages he/she may have against USA Swimming, New England Swimming, The Cape Cod Swim Club, The Massachusetts Maritime Academy, the Commonwealth of Massachusetts for any and all injuries suffered by him/her at said meet.

                _____________________________

                Signature: Authorized Team Official

Names and phone numbers of Certified Officials from your club:

go to NES entry form for page 2