Winter Specialty Meet

EBAC

Annual Fall Specialty  Swim Meet

November 9, 10 & 11, 2001

 

Name of Team________________________________ Abbreviation____________

Team Address  ________________________________Phone__________________

 

Coach_____________________________ 
Phone (day time)_________ (night time)________

 

Contact Person_______________________________ 
Phone (day time)____________ (night time)_____________

 

2nd Contact Person___________________________ 
Phone (day time)______________ (night time)_____________

 

NUMBER OF ENTRIES:

Female______________ X  $2.50= _____________   

Female distance_______  X $4.00= ______________

Male_______________  X $2.50=_______________

Male distance________   X $ 4.00=_______________

               TOTAL  =_______________

** Hand written (entered into computer by hand) entries, ADD 50 cents to above prices!

Entry deadline: Wednesday October 31^st , 2001.

 

Make check payable to:

East Bay Aquatic Club

 

Mail check and ALL entries to:

Roger D. Mooney

113 Lindy Avenue

Riverside, RI. 02915    (e-mail rmooney469@aol.com)

Any swimmer, whose entry is accepted, will for himself/herself, his/her heirs or executors and administrators waive and release any and all rights and claims for damages he/she may have against United States Swimming, New England Swimming, East Bay Aquatic Club,  East Providence High School, the City of East Providence or any of their officers for any and all injuries suffered by him/her at said meet.

_____________________________________

Authorized Club Officials Signature

Name_________________________________

Title__________________________________