CENTRAL
VERMONT WAVEMAKERS
ERIK
J. DEMASI SCHOLARSHIP MEET
“GO
THE DISTANCE MEET”
NOVEMBER
17, 2001
NORWICH
UNIVERSITY, NORTHFIELD, VERMONT 05663
SANCTION # NE-01-67
NAME OF
TEAM:_________________________________________
ABBREVIATION:______________
TEAM MAILING ADDRESS:______________________________________________________
CITY, STATE, ZIP:
______________________________________________________________
COACH:______________________________________________________________________
CONTACT PERSON:____________________________________________________________
CONTACT PERSON MAILING
ADDRESS:_________________________________________
CITY, STATE, ZIP:
_____________________________________________________________
CONTACT PERSON PHONE NO.
____________________
E-MAIL ADDRESS:_________________________________
PLEASE PROVIDE NAMES OF
OFFICIALS WHO COULD HELP AT THE MEET:
___________________________________________________________
___________________________________________________________
___________________________________________________________
|
|
# of entries |
Electronic |
Non-electronic |
Total |
|
Individuals |
|
$2.50 |
$3.00 |
|
|
400 IM Ind |
|
$4.00 |
$4.50 |
|
|
Total Events |
|
|
|
|
|
Relays |
|
$7.00 |
|
|
NUMBER OF ENTRIES:
ENTRY DEADLINE: November 2, 2001
PLEASE MAKE CHECKS PAYABLE
TO; Central Vermont Wavemakers
|
Marie Chilson |
|
100 Shaw Circle |
|
Northfield, VT 05663 |
PLEASE MAIL TO:
ANY SWIMMER WHOSE ENTRY IS ACCEPTED, WILL FOR HIMSELF, HIS HEIRS OR EXECUTORS AND ADMINISTRATORS WAIVE AND RELEASE ANY RIGHTS AND CLAIMS FOR DAMAGES HE/SHE MAY HAVE AGAINST UNITED STATES SWIMMING, NEW ENGLAND SWIMMING, CENTRAL VERMONT WAVEMAKERS, OR ANY OF THEIR OFFICERS, OR NORWICH UNIVERSITY FOR ANY AND ALL INJURIES SUFFERED BY HIM/HER AT SAID MEET.
______________________________________________
Signature, Authorized Team Official