SAN DIEGO-IMPERIAL MASTERS SWIM CONSOLIDATED ENTRY CARD 

Event                                     Event
No.     FREESTYLE                         No.     BREASTSTROKE
         (Submitted Time)                          (Submitted Time)

_____    50      ____:____.____           _____    50      ____:____.____

_____   100      ____:____.____           _____   100      ____:____.____

_____   200      ____:____.____           _____   200      ____:____.____

_____   400/500  ____:____.____           Event
                                          No.     BUTTERFLY
_____   800/1000 ____:____.____                    (Submitted Time)         

_____  1500/1650 ____:____.____           _____    50      ____:____.____    
                                      
Event                                     _____   100      ____:____.____
No.     BACKSTROKE                    
         (Submitted Time)                 _____   200      ____:____.____

_____    50      ____:____.____           Event
                                          No.     INDIVIDUAL MEDLEY
_____   100      ____:____.____                    (Submitted Time)

_____   200      ____:____.____           _____   100      ____:____.____      

ATTACH COPY OF YOUR USMS CARD             _____   200      ____:____.____    
TO THIS CONSOLIDATED ENTRY CARD       
(USMS & SI LMSC REQUIREMENT)              _____   400      ____:____.____    


NAME______________________________________________________ MALE____ FEMALE____

USMS#______-__________ PHONE(______)______-________ e-MAIL ___________________

BIRTHDATE_____________ AGE______ CLUB_________________________________________

NAME & DATE of MEET___________________________________________________________

No. of EVENTS ENTERED ____ x FEE $______ = $_________ TOTAL ENTRY FEE DUE

 "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 COMMITTEES, THE CLUBS, HOST FACILITIES, MEET SPONSORS, MEET
COMMITTEES, OR ANY INDIVIDUALS OFFICIATING AT THE MEETS OR SUPERVISING SUCH
ACTIVITIES.  In addition, I agree to abide by and be governed by the rules of
USMS."

PLEASE SIGN ____________________________________________DATE_______________ 

___________________________________________________________________________
Mail signed, consolidated entry card + entry fee to Meet Director/ Entry
Chairman for the meet you are entering.  Check entry form/information sheet
for correct entry fee (and "payable to"), mailing address, due date, and event
information or requirements.  Late or incomplete entries may be rejected.