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 “Mini Splash”for Puddle-Jumpers
A $5 entry donation is due with this form. Make all checks payable to the “Clearfield Aquatic Club”.
Entry Deadline: Saturday, July 11, 2009 Event Date: Tuesday, July 14, 2009
Return entries to the Clearfield Community Pool or _____________
Swimmer Name: ________________________________________________________ Age: __________
Parent/Guardian name(s) _____________________________________ Phone number: ___________________
I, _____________________________, give my permission for my child, _____________________________, to participate in the Splash for Cash “Mini Splash” 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 ___________________________________________________________________
________Cut here and keep bottom portion_________
2009 Splash for Cash “Mini Splash” Rules
·All participants must obey all Clearfield Community Pool rules. Lifeguards and Event Organizers have the right to disqualify any swimmer for rule violations.
·Children must be accompanied by an adult as per Community Pool rules. This person will serve as the child’s lap counter.
·The Mini Splash is designed for the non-lap swimmer, any age .
·Each participant must submit a $5 donation with their entry form. The balance of their donations is due at registration on the day of the event.
·No flotation devices are permitted. No extra clothing or accessories are permitted while in the pool.
·Any combination of walking, jumping, floating or beginner stroke-swimming is permitted, as long as the participant can make their way safely across the shallow section of the pool. Puddle-Jumpers have 15 minutes to complete their laps.
·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, 2009; start time: 5:00 PM.
