Winter Specialty Meet
EBAC
Annual Fall Specialty
Swim Meet
November 9, 10 & 11, 2001
Name of Team________________________________
Abbreviation____________
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:
Make check payable to:
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__________________________________
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