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PX3 Speedo Winter Elite Meet (2021) Liability Release Form
Event Dates: December 16-19, 2021
Event Address: Village of Pleasant Prairie RecPlex Aqua Arena 9900 Terwall Terrace, Pleasant Prairie, WI
Contact us at (262) 947-0437 or
RecPlexAquatics@plprairie.com
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Please Pick the Best Option
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Athlete
Coach
Official
Volunteer
Vendor
Participant Full Legal Name (First, Middle Initial, Last)
*
Your answer
Name of Parent/Guardian (must be a parent/guardian filling out this form if participant is a minor)
Your answer
Email of participant or parent/guardian (if participant is a minor)
*
Your answer
Phone Number of participant or parent/guardian (if participant is a minor)
*
Your answer
Swim Team or Organization Represented
*
Your answer
Days you/participant will be competing in (or at) the Swim Meet
*
Thursday, December 16, 2021
Friday, December 17, 2021
Saturday, December 18, 2021
Sunday, December 19, 2021
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