SECOND ANNUAL ST. LOUIS AREA MASTERS ONE-MILE AND TWO-MILE OPEN WATER SWIM
	at Sunnen Lake (YMCA of the Ozarks), Potosi, Missouri
	DATE: Sunday, July 6, 2003. SANCTIONED BY: Ozark LMSC for USMS Inc., Sanction #4738

USMS RELEASE: “I, the undersigned participant, intending to be legally bound, hereby certify that I am physically fit and have not been otherwise informed by a physician. I acknowledge that I am aware of all the risks inherent in Masters Swimming (training and competition), including possible permanent disability or death, and agree to assume all of those risks. AS A CONDITION OF MY PARTICIPATION IN THE MASTERS SWIMMING PROGRAM OR ANY ACTIVITIES INCIDENT THERETO, I HEREBY WAIVE ANY AND ALL RIGHTS TO CLAIMS FOR LOSS OR DAMAGES, INCLUDING ALL CLAIMS FOR LOSS OR DAMAGES CAUSED BY THE NEGLIGENCE, ACTIVE OR PASSIVE, OF THE FOLLOWING: UNITED STATES MASTERS SWIMMING, INC.; THE LOCAL MASTERS SWIMMING COMMITTEE (OZARK); THE CLUB (ST. LOUIS AREA MASTERS, INC.;THE HOST FACILITIES; MEET SPONSORS; MEET COMMITTEES; OR ANY INDIVIDUALS OFFICIATING AT THE MEET OR SUPERVISING SUCH ACTIVITIES. In addition, I agree to abide by and be governed by the rules of USMS. Finally, I specifically acknowledge that I am aware of all the risks inherent in open water swimming and agree to assume those risks.”

SIGNATURE:__________________________________________	DATE:__________________________
NAME:_______________________________________________	AGE ON RACE DAY:_______________
ADDRESS:____________________________________________	PHONE:_________________________
CITY:_______________________________STATE:__________	ZIP CODE:______________________
BIRTHDATE:__________________________________________	SEX:___________________________
CLUB NAME:__________________________________________	USMS #:________________________
EMAIL ADDRESS:______________________________________	CLUB CODE:_____________________
ENTRY FEE:_____________________ $25 ($40 if after July 3, 2003)
ONE-DAY FEE:___________________ $14 enclosed for One-Day USMS Registration fee
YMCA Discount:_________________ -$5 (enclose a photo copy of individual or family YMCA membership card)
Additional Lunch _______________ ________ x $7.95 ________ x $6.00 _____ Free
TOTAL ENTRY: _______________