Atlantic City Pageant Ocean Swim

Saturday, August 30, 2003 9:45am

States Avenue and the Beach ¨ Atlantic City, NJ

 

Checks payable to: Pageant Swim, 1 Circle Drive, Margate, NJ 08402

For further information call 609-347-5466 or visit www.apexswim.com

 

 

Entry Form for 2003 Atlantic City Pageant Swim

 

Swimmer_______________________________________________Age ____ Sex____



(Address)                                                           

 ____________________________________ T-shirt Size: S____ M____ L____ XL____

(Phone - for cancellations)

 

This event is open to all swimmers and will be conducted according to current USA Swimming rules. Swimmer’s age is as of the day of the race. $20 early entry fee must be enclosed and received prior to 8/24/03 - Race Day fee is $25
Make checks payable to: "Pageant Swim" and mail to: 

Pageant Swim

1 Circle Drive

Margate, NJ 08402

 

Waiver and Release

In consideration for accepting this entry and granting of the right to participate in this event I/we, the undersigned intending to be legally bound hereby for myself/ourselves, my/our heirs, waive and release for any and all claims, damages, costs, or expenses which may arise against personal damages I may have against Atlantic City Beach Patrol, the City of Atlantic City, Middle Atlantic Swimming, USA Swimming and/or any other person whomsoever for any and all injuries, illness, including death that may result from my participation in said event. I/we represent and affirm that I/we am/are in proper physical condition to participate in this event as verified by a licensed physician and have sufficiently trained for the completion of this event. The undersigned has read and voluntarily signed this Waiver and Release.

 

______________________________________________________________________
Signature                                                       Date

 

______________________________________________________________________
Parent's Signature (if under 18)                  Date