Panama City Swim Team - Sign-Up Form #4

Panama City Swim Team Inc.
PO Box 15651
Panama City, FL 32406
Tel: 850-872-6701

GENERAL RELEASE AND WAIVER

For and in consideration of my child’s participation in the activities of the Panama City
Swim Team Inc. (herein after PCST), on behalf of myself and

my minor child, ____________________________ I do hereby release, acquit, and
covenant not to sue PCST, its officers, employees, sponsors, or volunteers, and Gulf
Coast Community College, its officers, employees, sponsors, or volunteers, from any
and all liability for any claim arising from my child’s participation in activities of PCST,
whether at Gulf Coast Community College or otherwise.

This release includes liability arising from any and all sources, including the negligence or
gross negligence of the releasees, their officers, employees, sponsors or volunteers,
whether to myself, my child, or other family members. I expressly recognize that swimming,
including travel to and from meets, participation in conditioning, training, coaching, or
competition, involves risk and expressly assume to myself all such risk.

Dated this ______ day of ____________________________________

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                   Print Name


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                                       Signature of Parent / Guardian