====> This form must accompany entries along with NESwimming master entry list <====

Club Name________________________________________________________   Abbreviation  ___________

Club Address __________________________  City_________________   State_______   Zip code __________

Head Coach  ____________________________________________    Phone #  __________________________ 

Club Phone # __________________________  E-Mail*  __________ FAX # __________________________ 

* Results will be sent the following Monday AM if address furnished

Any swimmer whose entry is accepted will, for himself, his heirs, executors and administers, waive and release any and all rights and claims he may have against the Charles C. White Pool, Haverhill High School, the City of Haverhill,  the New England Barracudas Swim Team and New England Swimming for any and all injuries suffered by himself at this meet.

 Contact Person I (please print neatly) ______________________________________________________

Phone Number (Days)   __________________________   (Evenings)   __________________________ 

 Contact Person II (please print neatly) ______________________________________________________

Phone Number (Days)   __________________________   (Evenings)   __________________________ 

Entries should be sent Certified mail, return receipt requested to: Snowball 2000, c/o 62 Jasper St., Haverhill, Ma.  01830  Make checks payable to NEB Snowball Classic.

                                                    Amount Enclosed

  Signature of Club Official_________________________ Position ____________________

(Do not write below this line)

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       Postmark Date __________  Received __________ Check # ______