Applicable to: Adult Lessons - Surrey Seals 4 - Burnaby Regional Group 3 Lessons Divisional Group 4 Lessons Seals 5 - Burnaby Provincial Group 5 Lessons Seals 6 - Burnaby Seals 7 - Burnaby National Group 6 Lessons Seals 1 - Surrey Seals 2 - Surrey Seals 3 - Surrey Seals 4 - Surrey Seals 5 - Surrey Seals 6 - Surrey Seals 7 - Surrey

I, the parent/guardian of the swimmer(s) named above agree both to allow him/her to participate in any

meets or practices sponsored by DYNAMO SWIM CLUB and that he/she will abide by the rules of the

club and of Swim BC, recognizing the potential for physical injury associated with swimming. I hereby

release, discharge, and/or indemnify DYNAMO SWIM CLUB from any claim by or on behalf of the athlete

as a result of his/her participation in club practices and/or Swim BC and SNC sanctioned swim meets.

In addition, I give consent for emergency medical care prescribed by a fully licensed doctor or dentist

which may be necessary to preserve the life, limb or well-being of my dependent.