STATEMENT OF RELEASE AND CONSENT FORM
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.