Medform

WAIVER RELEASE FORM 2003

I/We, __________________________________as the parent(s)/gardian(s) of

__________________________________ hereby give my/our approval to

participate in any and all summer swim team activities. I/We assume all risks

and hazards incidental to such participation, including transportation to and

from the activities; and I/we do hereby waive, release, absolve, indemnify and

agree to hold harmless The Glens Swim Club, Southwest Houston Recreational

Swim League, the organizers, sponsors, supervisors, participants, Board of

Directors, volunteers and coaches from any and all claims arising out of injury

to my/our child(ren), whether the result of negligence or for any other cause.

______________________________             __________________________
(Signature of parent/guardian)                        (Signature of parent/guardian)

______________________________              __________________________
(Date)                                                          (Date)

HOSPITAL TREATMENT RELEASE FORM 2003

In case of emergency, and in the event I/we, _________________________ as the

parent(s)/guardian(s) of _________________________________ cannot be reached by

phone, I/we authorize a Glens Swim Team representative to take immediate steps for

emergency treatment. The Glens Swim Team or representative will not be help

responsible for payment of medical fees.

_______________________________         ____________________________
(Signature of Parent/Guardian)                    (Signature of Parent/Guardian)

_______________________________          ___________________________
(Date)                                                       (Date)

_______________________________          ___________________________
(Home Phone Number)                                         (Home Phone Number)

_______________________________           ___________________________
(office/cell phone number)                            (office/cell phone number)