Ski-n-Swim Registration Form

General Information

* - required

Please provide the name and email address for each person attending the event. To register more than one person, click the 'Add' link.

In order to participate in any Ski-n-swim 2010 event you need to register. Please, fill out the appropriate parts of the form. You will be charged $20 registration fee plus any other elected fees for ski tickets, swim meet or water polo tournament. If you are only participating in swim meet or water polo tournament, you will be charged $10 fee.

If you have any questions or comments about registration please contact us.

Only successfully paid registration forms will be reviewed and approved!

Participant Information

First Name: *

Last Name: *

Birth Date: * Date must be in the following format: MM/DD/YR

Gender: * MaleFemale

Street Address: *

Address continued:

City: *

State:

Province

Zip/Postal Code: * Please enter your post code in the following format: 80145

Country

Phone: *

Email: * Please enter a valid email address

Emergency Contact

First Name: *

Last Name: *

Phone: *

Email: Please enter a valid email address

Ski-n-Swim Events

Please, select an event you want to participate in. Please, select the events you will actively participate in. For example, if you are going to swim in the swim meet, check "I will participate in swim meet" and fill out the appropriate section below. The same applies for the water polo. If you are planning to come and cheer and watch the swim meet and water polo, don't select those events. You can come and watch for free. No registration for those is required.

You will need to select the box for the event you participate in, otherwise it will not be active for accounting purposes. If you see an event below that you decided to attend, please come back here and and make sure it is checked here. Thank you. Let us know if you have questions at skiandswim@gmail.com.

Swim Meet I will participate in Swim Meet

Swim Meet - Saturday February 13th 2010

Please, check the event you will attend and indicate your time for the event
Location: Steiner Aquatic center, 645 South Guardsman Way, Salt Lake City. Warm-ups start at 11:00am, competition begins at noon. All swimmers must be registered with USMS (proof is required). USMS/Utah annual registration for 2010 will be offered on deck for $40. USMS/Utah one time swim meet event registration will be a $25 fee. You can also register for USMS at http://www.usms.org/reg/. Same day deck registration accepted until 11.30 am on Saturday. A $15 deck entry fee will be charged.

USMS#: Please enter United States Masters Swimming membership number. Please bring your USMS membership card to the Opening Social or Swim Meet for verification.

Swim Meet Team Name: If you know your Swim Meet team name, please enter it here

200y Medley Relay Time

* If you timed yourself, please enter your Time (i.e. 00:02:30). Otherwise leave 00:00:00

200y Freestyle Time:

* If you timed yourself, please enter your Time (i.e. 00:02:30). Otherwise leave 00:00:00

100 Individual Medley Time: * If you timed yourself, please enter your Time (i.e. 00:02:30). Otherwise leave 00:00:00

50y Freestyle Time: * If you timed yourself, please enter your Time (i.e. 00:02:30). Otherwise leave 00:00:00

50y Butterfly Time: * If you timed yourself, please enter your Time (i.e. 00:02:30). Otherwise leave 00:00:00

500y Freestyle Time: * If you timed yourself, please enter your Time (i.e. 00:02:30). Otherwise leave 00:00:00

200y Freestyle Relay Time: * If you timed yourself, please enter your Time (i.e. 00:02:30). Otherwise leave 00:00:00

100y Freestyle Time: * If you timed yourself, please enter your Time (i.e. 00:02:30). Otherwise leave 00:00:00

50y Backstroke Time: * If you timed yourself, please enter your Time (i.e. 00:02:30). Otherwise leave 00:00:00

50y Breaststroke Time: * If you timed yourself, please enter your Time (i.e. 00:02:30). Otherwise leave 00:00:00

400y Freestyle Time: * If you timed yourself, please enter your Time (i.e. 00:02:30). Otherwise leave 00:00:00

200y Martini Time: * If you timed yourself, please enter your Time (i.e. 00:02:30). Otherwise leave 00:00:00

Agreement: * I, the undersigned participant, intending to be legally bound, hereby certify that I am physically fit and have not been otherwise informed by a physician, I acknowledge that I am aware of all the risks inherent in Masters Swimming (training and competition), including possible permanent disability or death, and agree to assume all of those risks. AS A CONDITION OF MY PARTICIPATION IN THE MASTERS SWIMMMING PROGRAM OR ANY ACTIVITIES INCIDENT THERETO, I HEREBY WAIVE ANY AND ALL RIGHTS TO CLAIMS FOR LOSS OR DAMAGES INCLUDING ALL CLAIMS FOR LOSS OR DAMAGES CAUSED BY THE NEGLIGENCE, ACTIVE OR PASSIVE, OF THE FOLLOWING; UNITED STATES MASTERS SWIMMING, INC., THE LOCAL MASTERS SWIMMING COMMITTEES, THE CLUBS, HOST FACITLITIES, MEET SPONSORS, MEET COMMITTEES, OR ANY INDIVIDUALS OFFICIATING AT THE MEETS OR SUPERVISING SUCH ACTIVITIES. In addition, I agree to abide by and be governed by the rules of USMS.

Date: * Enter Date in the following format: MM/DD/YYYY

Signature: * Please, enter your name to sign the agreement above

Swim Meet Total:$

Water Polo I will participate in Water Polo

Water Polo - Saturday February 13th 2010

Location: Steiner Aquatic center, 645 South Guardsman Way, Salt Lake City. Tournament begins right after swim meet ends, approximately around 2.30 pm.

Water Polo Team Name: Please enter Water Polo team name, otherwise, check "Assign to a Team"

Assign: Please assign me to a team

Water Polo Total:$

Ski Out I will participate at Ski Out Day

Ski Out Date - Saturday February 13th 2010

Please, indicate to which events you would like to purchase tickets

Ski lift and lunch ticket $94

Lunch only ticket $27

Ski Out Total:$

Social Events: I will participate in Social Events

Social Events

Please, indicate how many people will attend each event

We will send you more details about social events after the registration closes.

	Opening Social Participants:	Dessert Night Participants:	Closing Social Participants:
	Friday, February 12th , 8.00 PM - 10.00 PM - Come pick up your registration packets and meet the Ski-n-swim participants at Trolley Square.	Saturday, February 13th, 9.00 PM - 11.00 PM - enjoy drinks and desserts after a hard day in the pool at various locations	Sunday, February 14th, 8.00 PM - 10.00 PM - Conclude a great weekend with us, say goodbye to newly made friends.

Social Total:

Comments:

Total Amount Due

Total:$