Regency Riptides Waiver
Please print, sign and bring to registration on April 14th, 2013.
I, my heirs, executors, administrators and assigns, hereby release the Cambridge-Wyndfall at Regency Homeowners Association, Tarheel Swimming Association, pool managers and operations, volunteers and coaches from above named participants’ injury or loss which might occur during participation and travel to and from planned events, including injury or loss arising form or contributed to by any physical impairment or defect that said participants may have, whether latent or patent, and I agree that sponsors and promoters are under no obligation to provide physical examination or other evidence of said participants’ fitness to participate in such activities, the same being my sole responsibility.
Swimmer Name and Age ___________________________________
Parent/Guardian Name, please print: ___________________________________
Parent/Guardian Signature: _______________________ Date: _____________
OFFICE USE ONLY
Check # __________ Date: ___________ Amount: __________
Web Registration Completed: _______
4 Volunteer Positions Committed: _______