Athlete's Name *

First Name

Last Name

Milford Meltdown Masters Meet

No. I am not planning to swim in the Milford Meltdown Masters Meet.

Yes, I will sign up to swim in the Milford Masters Meet

Yes, I would like to be considered for a USADSS Relay

Team Building Activity: WhirlyBall at 4pm on Saturday (min height requirement of 54 inches)

Yes, I want to play WhirlyBall

No, I am unable to play Whirlyball

Athlete is medically cleared to participate in the clinic. *

Yes

No

Parent/Guardian Attending Name *

First Name

Last Name

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Phone

(###)

###

####