Print & Fill-out this application and take it to the Pool
www.clearfieldswimming.org is sponsored by the Clearfield Aquatic Club
and is neither affiliated with nor endorsed by the
Clearfield Area School District , The Clearfield YMCA nor the Clearfield Community Pool Association
Splash for Cash
Entry Deadline: Saturday, July 11, 2009 Event Date: Tuesday, July 14, 2009
Return entries to the Clearfield Community Pool or _____________
A $5 entry donation is due with this form. Make all checks payable to the “Clearfield Aquatic Club”.
Swimmer Name: _____________________________________________________________ Age: __________
Swimmer Phone number: _________________ Swim Team member? (Circle one) Yes No
If under the age of 18, complete the section below:
Parent/Guardian name(s): _______________________________________________________
Phone number: ___________________
I, _____________________________, give my permission for my child, _____________________________, to participate in the Splash for Cash swim event being held July 14, 2009 at the Clearfield Community Pool.
I understand the rules of the event and will be ultimately responsible for all money raised by my child.
Parent Signature ___________________________________________________________________
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2009 Splash for Cash Rules
·All participants must obey all Clearfield Community Pool rules. Lifeguards and Event Organizers have the right to disqualify any swimmer for rule violations.
·Participants under the age of 18 must have a signed parental permission. Children must be accompanied by an adult as per Community Pool rules.
·Each swimmer must submit $5 in donations with their entry form. The balance of their donations is due at registration on the day of the event.
·Each swimmer will have ½ hour to complete as many 25-yard laps as they can and must provide their own lap counter.
·Each swimmer must be able to swim at least one 25-yard length of the pool, any stroke, and may not walk along the bottom of the pool or pull themselves along on the lane lines or wall.
·No flotation devices are permitted. No extra clothing or accessories are permitted while in the pool. “Sharpie” Body Art is OK, but No Obscenities.
·Parents should use their discretion when allowing their children to solicit donations. Your child’s safety comes first!
·Event Date: Tuesday, July 14, 2009, rain date Tuesday, July 21; each swimmer will be given a start time between 5:00 and 7:30 PM.
