2012 13&Over Short Course Championships Meet Waiver Form
In consideration of the acceptance of this entry, I/we hereby, for myself/ourselves, my/our heirs, administrators and assigns, waive and release any and all claims against USA Swimming, Inc., Wisconsin Swimming, Inc., the Walter Schroeder Aquatic Center., The host, Lake Country Swim Team and all other staff for injuries and/or expenses incurred by me/us at the meet, or while on the road to and from the meet.  Your entry is complete when you have attached a .pdf of your meet entry report, meet entry fees, bonus swim spreadsheet if you've entered bonus swims and a meet entry file that is compatible with Hy-Tek Meet Manager.
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Name of Club Official completing this waiver *
this is an electronic signature, considered the same as a written signature
Title of the Club Official completing this waiver *
ie. Entry Chair, Head Coach, Club President
Email address of the person to contact for questions regarding this entry *
Mobile phone of the person to contact for questions regarding this entry *
ie.  2625551111
Name of the primary coach at the meet *
Email address of the primary coach at the meet *
Mobile phone of the primary coach at the meet *
ie.  2625551111
Name of coach 2 at the meet
Name of coach 3 at the meet
Club Name or Unattached *
Club Code or UNAT *
2 - 4 letter code that is usually printed in a heat sheet
Club address or PO Box *
Club address line 2
City *
State *
Zip Code *
Your Entry is complete when you have attached the following Reports / Attachments to the email you send to the entry chair: *
please check off the boxes below
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