2002 Short Course Pentathlon - Sunday Only

 Sanction by: New England Swimming, Inc.  No. NE-02-17

Entry Form Cover Sheet

Please answer all questions and sign where requested to sign:

Team_______________________________________________________

Address_____________________________________________________

City ____________________________________ Zip Code______________

 

E-mail address if available_______________________________________

e-mail address if cuts are needed__________________________________

If results go to a different address please add this below:

_________________________________________________________________________

 

MAIL ENTRIES TO:       Isabelle Fraser

                                             125 Franklin Rd.,

                                              Longmeadow, Ma. 01106      Phone 413-567-3415

 

Make Checks payable to:  Pioneer Valley Aquatic Club (PVAC)

Entry Deadline:                 Wednesday, Dec. 26, 2001.  Enclose a stamped self addressed postcard

                                               if you want proof of entry receipt.  If you use express mail please take the

                                               time to sign the waiver so it may be left.  If you do not sign the waiver the

                                               entry may sit in the post office for a few days.  I do not go each day.

Entry Requirements:       All entries should include an entry form.   The proper entry fees in one club

                                             check.   If sending in a hand entry please add the appropriate entry fee.

                                             Seed cards are not needed.      

Meet Limit:                        The meet will be cut by date of receipt and by time depending on whether  

                                             a session is full.  This could mean that a Club may have swimmers in one

                                             session and not another. 

......................................................................................................................................................................

             Individual Entries                      # of entries x $2.50                 =              Total

                 10 & Under                               ________                                           ________

                 11 & 12                                      ________                                          ________

                 13 & 14                                      ________                                          ________

                 15-18                                          ________                                          ________

             Relay Entries                              # of entries x $7.00               =               Total

                 10 & Under                             ________                                             ________

                 11 & 12                                    ________                                                    ________                          

                 13 & 14                                    ________                                             ________

                 15-18                                        ________                                             ________

                  Check #____________Enclosed in the amount of $__________________

......................................................................................................................................................................

Any swimmer whose entry is accepted, will, for himself, his heirs, executors, and administrators,

waive and release any and all rights and claims for damage he may have against United States

Swimming, Inc., New England Swimming, Inc., Pioneer Valley Aquatic Club, and Springfield College

for any and all injuries suffered by him or her at said meet.

 

______________________________                                           ___________________

Signature of Club Official                                                                     Date                                               

 

Please remember if you do not submit your entries on a disk, that the cost per individual entry is $3.00.