WATER DEPTH: The depth of the pool at the start end is 12 feet. The depth at the turn end is 4 feet.

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1 LOCATION: CLEVELAND STATE UNIVERSITY, Robert F. Busbey Natatorium, 2451 Euclid Ave., Cleveland, OH (downtown Cleveland Euclid Avenue at East 24 th Street). CSU has been the site of numerous USA and collegiate championships. POOL: 50 meters by 9 lanes, Colorado electronic timing and scoreboard; spacious locker rooms, deck area, and spectator section; continuous warm-up available. POOL MEASUREMENTS: The competition course has been certified in accordance with C (4). The copy of such certification is on file with USA Swimming. WATER DEPTH: The depth of the pool at the start end is 12 feet. The depth at the turn end is 4 feet. STARTING TIMES: Morning session s warm-ups will be 7:30 8:15 AM, with competition starting at 8:20AM. The 45-minute afternoon session warm-up will begin 15 minutes after the conclusion of the morning session. Finals on Friday and Saturday will not begin before 6:00 PM after a 45-minute warm-up. Estimated timelines will be posted on the or websites by Wednesday June 13, At the discretion of the Safety Director, warm ups may be split by gender or age group or team. ENTRY DEADLINE: This meet always closes out quickly. There will be two acceptance dates for entries. The first acceptance date of May 10 th no earlier than 9:00 PM is reserved for swimmers entering events in which they have achieved a AAAA L cut. These times will be verified using the SWIMS database. The second acceptance date is Monday, May 14 th no earlier than 9:00 PM for additional events for previously entered swimmers and all other swimmers. Final date to accept all entries by or hard copy is 11:59PM on June 4, Please do not trust your organization s server time or your computer s time when submitting entries. It is suggested that you sync your computer time with the official U.S. time clock found at prior to submitting your entries. You should receive an automatic response when your reaches the entry person. This auto response does not verify that you included the entry nor does it verify that you are in the meet. The meet will be closed before the entry deadline if the sessions become unmanageable. All hard copy, including the Cleveland State University waiver (attached) and fees must be received by June 4, You may e- mail the entry chair to request the event file or download the event file from or at Phone entries will not be accepted. There will not be a refund of entry fees after the meet is closed or after the entry deadline, whichever comes first. Updated times for events already entered will be accepted until noon June 11th but only through the team entry file. Mail/ entries to: Beth Forsythe, 4977 Countryside Road, Lyndhurst, Ohio 44124; lesdbusbeyentries@gmail.com. Only unattached athletes will be accepted individually. All others please submit entries by Hy-Tek, and include a hard copy and the entry summary sheet. ENTRY FEES: Individual events $5.00 (US), Relays, $10.00 (US) and a $2.00 per swimmer surcharge (for LESI). There is a $1.00/swimmer handling fee for paper entries. Make checks payable to SPIRE INSTITUTE. ENTRY LIMITATIONS: Swimmers may compete in 3 individual events per day on Friday, Saturday, and Sunday exclusive of relays. Swimmers must have achieved the listed cut-off time to enter an event where applicable. Teams are limited to two entries each relay. Time trials count toward daily limitations. DECK ENTRIES: Deck entries, on a space available basis, will be accepted up to 40 minutes before the start of each session at $10.00 per individual event and $15.00 per relay event. Deck entrants will be seeded at no time but will be eligible to score. Swimmers who wish to scratch one event in order to enter another, must deck enter into the other event. There will be no refund for the scratched event. Deck entrants who are new to the meet must show proof of USA Swimming registration and pay the $2.00 swimmer surcharge. On deck USA Swimming registration will be available for athletes but not available for coaches. Swimmers closed out of events will be notified as the events are seeded and receive refunds in the deck entry office. 1

2 ELIGIBILITY: Swimmers must be current athlete members of USA Swimming and have met the time standard requirements where applicable. Age is as of the first day of the meet, June 15, Coaches must be current coach members of USA Swimming and must check in for each meet day or session they attend. All coaches must display the deck pass (wristband is required to be worn by all coaches) issued by the meet host. UNSUPERVISED SWIMMERS: Coaches who are entering swimmers but will not be at the meet should arrange ahead of time for another coach to supervise their athletes. Swimmers unaccompanied by their coaches or for whom arrangements have not been made must contact the Meet Director or Meet Referee who will assist the athlete in finding coach supervision. Any swimmer entered in the meet must be certified by a USA Swimming member coach as being proficient in performing a racing start or must start each race from within the water. When unaccompanied by a member coach, it is the responsibility of the swimmer or the swimmer s legal guardian to ensure compliance with this requirement. BONUS EVENTS: 13 & 14 year old swimmers who have achieved fewer than 3 individual event time standards may supplement their entry with one bonus events. The 400, 800, and 1500 freestyle, and 400 IM are not eligible bonus events. Swimmers entering bonus events should be entered at their actual time. Please be certain to check the box on TM indicating bonus for each event that is a bonus entry. QUALIFYING TIMES: Please see the event listings. Swimmers must be equal to or faster than the cuts listed. Enter at either short course yards(y) or long course meters (L) times. Converted times may not be used. Meet management will convert non-conforming times. All swimmers must have an actual time to enter an event-nt is not acceptable. The host team reserves the right to enter their swimmers slower than the cut. FASTER THAN: Swimmers should enter an event only if they have achieved the listed time standard for that event. Teams of swimmers who fail to achieve the qualifying time at the meet will receive a notice of those times that cannot be verified in the SWIMS database. Teams shall submit proof of time or a fine of $10.00 for each swim listed in the notice. Failure to resolve time verification issues within one week of receipt of notice shall result in debit to the team s account in the amount of the fine. Unattached swimmers will receive similar notice. SPIRE LESD reserves the right to enter its own swimmers without regard to qualifying times. Qualifying times for 50-meter events will be waived for swimmers with a disability. Swimmers with a disability may enter an event (such as the 100 free) and swim it with a longer yardage event (such as the 200 free) provided his/her time for the lesser yardage event (100 free) is equal to or faster than the listed qualifying time for the longer yardage event (200 free). SWIMMERS WITH A DISABILITY: Entries for swimmers with a disability should be handled in the following manner: (1) enter the swimmer in the Hy-Tek database (or on the regular entry form); (2) list in the accompanying the Hy-Tek entry file (or on a separate sheet of paper) the name of the swimmer, the stroke(s)/distance(s) s/he wishes to swim, the entry times, the day/session s/he wishes to swim the event(s), and the manner in which s/he prefers to be seeded (with a longer distance or with a different age group); and (3) provide any information about special accommodations needed by the swimmer. The final determination of seeding will be made by the Meet Referee after consultation with the swimmer and his/her coach. CONDUCT: The meet will be conducted according to the rules set forth in the current USA Swimming Rules and Regulations. Events will be contested in a 50-meter course using 9 lanes. Friday and Saturday will be prelim/final format for all age groups except for breast, fly, the relays, all 400IM, all 400 free, and the Open 1500 free which will be timed finals. Sunday will be timed finals for all events. At finals on Friday and Saturday, consolations will be swum in the 15 & over/open events only, and will be swum first, followed by the final heat. 14 and under events will have A finals only. All timed final events will be swum in the prelim sessions, except for the 400 free which will have the fastest seeded heat each men and women swum at finals. Swimmers who do not wish to swim the 400 free in the finals session must indicate an early swim by placing a P next to their name on the check-in sheet. 11 & 12 year-olds are advised not to enter both the 50 and 200 of the same stroke in the butterfly or breaststroke. These events are back-to-back in the meet program and there will be no rest in between. Swimmers may have less than 15 minutes between these events so plan accordingly. CONDUCT OF DISTANCE EVENTS / HEAT LIMITATIONS: The IM and 12 & Un 400 free may be limited to the fastest 2 seeded heats each of men and women. The 12 & Un 400 free will not be scored separately by age groups. The 13/14 and Open 400 free may be limited to the fastest 4 seeded heats each men and women in each age group. The 800 & 1500 freestyle may be limited to the fastest 2 seeded heats of each men and women with the fastest heats swimming first, alternating women and men. Events may be consolidated, but scored separately, to help control the length of a session and to afford more swimmers the opportunity to participate. Those swimmers closed out of an event will receive a refund in 2

3 the deck entry office. We will publish on the number of heats that will be conducted in those events where heat limitations may apply by Wednesday, June 13, COACHES PLEASE NOTE: IF YOU ARE ENTERING SWIMMERS IN BOTH AGE GROUP AND OPEN EVENTS (13-14 & OPEN OR 15-OVER & OPEN), BE AWARE THAT THE LAKE ERIE SWIMMING 15 MINUTE RULE DOES NOT APPLY TO SWIMMERS COMPETING IN DIFFERENT AGE DESIGNATIONS WITHIN A SESSION. PLAN YOUR SWIMMERS EVENTS ACCORDINGLY. SEEDING & CHECK IN: All events will be deck seeded according to USA Swimming Rules. All swimmers must check in no later than 30 minutes prior to the start of their session. FOR the 1500 FREE - AN OPTION OF CHECKING IN VIA IS AVAILABLE lesdbusbeyentries@gmail.com - CHECK IN MUST BE RECEIVED BY NOON ON FRIDAY AND SWIMMER MUST BRING CONFIRMATION OF CHECK-IN WITH THEM TO THE MEET. Heat and lane assignments will be posted. Check-in sheets will be posted. Relay cards must be turned in upon call in order to be seeded. There is a clerk of course for 10 and under swimmers only. Lake Erie Scratch Rules will be in effect (Attached). In accordance with , events may be seeded together but scored separately. SCORING: Individual Events: Top 9 places: Relays: Top 9 places: Points accumulated in Open events will count toward individual high point awards. (Ex: A 12-year old finishing 9 in the Open 1650 will score one point in the age group) AWARDS: 14 & under Ind. Events: Medals 1-3, ribbons & under Relay Events: Medals 1-3 Individual High Point and Runner-up awards in the following age groups: 10 & UN, 11-12, 13-14, 15 & Over. Team High point awards will be given to the top 3 visiting teams TIME TRIALS: Time Trials will be held at the conclusion of the morning and afternoon sessions at the discretion of the meet director and meet referee. Time trials count toward daily limitations. Swimmers must sign up in advance at the deck entry office at a cost of $7.00 per individual event and $15.00 per relay event. Only swimmers who are entered in an individual event in the meet may participate in time trials. Time trials entries will close 90 minutes prior to the end of each session. SAFETY / WARM-UP PROCEDURES: Lake Erie Swimming safety guidelines and warm-up procedures will be in effect at all times. Coaches must maintain contact with their swimmers during warm-up. All entry into the pool for warm-up is feet first from the starting block end of the pool. There is no diving during warm-up, except in designated sprint lanes. The final 20 minutes of a 45-minute warm-up shall be conducted as follows: (a) Lanes 1, 8 & 9: push/pace from the start end of the pool (or general warm-up at the discretion of the Meet Referee or his/her designee). (b) Lanes 2 & 7: sprint lanes for racing starts from the starting block end of the pool, one length only and exiting the pool (c) Lanes 3-6: general warm-up, no diving or racing starts. Any or all of these lanes may be converted to sprint lanes at the discretion of the Meet Referee or his/her designee. Swimmers are to sprint one way and climb out at the far end of the pool. Swimmers may be removed from warmup for violating safety rules. Only swimmers registered in the meet may enter the pool during warm-up. No paddles or swim fins are permitted. Continuous warm-up is available in the adjacent 25-yard instruction pool. Use of audio or visual recording, including a cell phone camera, is not allowed in changing areas, restrooms, or locker rooms and is limited to only those areas marked as designated camera zones. In granting this sanction it is understood and agreed that USA Swimming shall be free from any liabilities or claims for damages arising by reason of injuries to anyone during the conduct of the event. COACHES: Psych sheets for coaches will be available in the deck-entry office which is near the CSU record board. Please keep your psych sheets for the entire weekend there is a limited supply. There may be a coaches meeting during warmups if necessary. ADMISSION: $4.00 daily or All Session passes with meet programs will be sold. Parking at CSU is $6.00. There is also meter parking; parking on Chester is free on Sat. and Sun. RESULTS: Results will be available on the website. Teams may request a back up of the meet by made to Marie Salibra at Marie@salibra.net. NOTE: Only athletes entered in the meet, working coaches, officials, and meet workers are allowed on deck. Other non-participants are expected to remain in the spectator area. 3

4 DISTANCE EVENTS: Volunteer timing help from the parents of distance swimmers is appreciated when these events begin. OFFICIATING OPPORTUNITY: Anyone that is a USA Swimming certified official is welcome and encouraged to join the Lake Erie Swimming (LESI) officials in officiating this meet. Please contact the LESI s Officials Chair, Frank Campbell, in advance of the meet if at all possible to let either know of your availability. We are also looking for anyone that is interested in becoming an official, for more information please contact the Official s Chair, Frank Campbell E -mail: facampbell@sbcglobal.net C0-MEET DIRECTORS: Kathy Quinn enkwinn@yahoo.com C , H ; and Wendy Banks SAFETY DIRECTOR: Maria Rimmerman mariarimmerman@gmail.com ENTRY PERSON: Beth Forsythe, 4977 Countryside Road, Lyndhurst, Ohio 44124; lesdbusbeyentries@gmail.com. DIRECTIONS: From I-77 NORTH, follow signs to I-90 east to E. 22 nd street exit, follow E. 22 nd north (left) to Euclid or Chester. From I-90 east or west, exit at Chester Ave., park on Chester or Euclid. From Ohio Turnpike, take I-77 or I-71 north to I-90 east (see above). HOTELS: see LESD website SPECTATOR EMERGENCY EVACUATION PLAN In the event of an alarm or an emergency requiring evacuation: Remain calm, walk to the nearest exit, and leave the building. Do not use the elevators. Do not attempt to go on deck or into the locker rooms. Swimmers will be directed by their coaches or meet workers to STILLWELL HALL ON THE WEST SIDE OF THE BUILDING (the scoreboard is on the west wall of the pool). 4

5 The Robert F. Busbey Invitational Meet Friday, June 15, 2012 Session 1: Schedule of Events 13 & Over Prelim/Finals 45-minute warm-up starts at 7:30AM; Meet starts 8:20AMm Friday: prelim/final format GIRLS Qualifying Time Age Group/Stroke Qualifying Time BOYS 1 2:30.49Y 2:51.49L IM 2:20.29Y 2:42.39L 2 3 2:26.99Y 2:47.29L 15 & over 200IM 2:15.09Y 2:35.89L 4 5 2:27.29Y 2:47.39L back 2:18.19Y 2:40.69L 6 7 2:23.89Y 2:44.29L 15 & over 200 back 2:12.39Y 2:31.29L 8 9 1:02.19Y 1:10.39L free 57.39Y 1:05.99L :00.79Y 1:08.59L 15 & over 100 free 55.19Y 1:03.09L :46.79Y 3:11.99L breast 2:36.29Y 3:01.99L :42.79Y 3:05.69L 15 & over 200 breast 2:30.09Y 2:54.29L * medley relay *Open 400 medley relay :08.99L 19:37.19Y *Open 1500 free# 18:00.99L 18:25.29Y 22 *Timed final events # may be limited to the fastest 2 seeded heats each of women and men with the fastest heats swimming first, alternating women and men All heats of the 1500 will be swum with the preliminary session. Friday, June 15, 2012 Session 2: Schedule of Events 12 & Under Prelim/Finals 45-minute warm-up starts 15 minutes after the end of AM Session Friday: prelim/final format GIRLS Qualifying Time Age Group/Stroke Qualifying Time BOYS 23 2:43.19Y 3:03.89L free 2:43.19Y 3:03.89L :20.19Y 3:48.59L 10 & UN 200 free 3:20.19Y 3:48.59L :26.39Y 3:57.59L * breast 3:26.39Y 3:57.59L breast & UN 50 breast free & UN 50 free :04.19Y 6:55.89L * IM# 6:04.19Y 6:55.89L *10& UN 200 free relay * free relay 42 * Timed final event # may be limited to the fastest 2 seeded heats each of men and women Session 3: Friday Finals will not begin before 6:00 PM after a 45-minute warm-up. Finals Orders of Events: 1,2,3,4,23,24,25,26,5,6,7,8,29,30,31, 32,9,10,11,12,33,34,35,36,13,14,15,16 5

6 The Robert F. Busbey Invitational Meet Saturday, June 16, 2012 Session 4: Schedule of Events 13 & Over Prelim/Finals 45-minute warm-up starts at 7:30AM; Meet starts 8:20AM Saturday: prelim/final format GIRLS Qualifying Time Age Group/Stroke Qualifying Time BOYS 43 2:13.79Y 2:31.79L free 2:05.29Y 2:23.29L :10.39Y 2:27.19L 15 & over 200 free 2:00.09Y 2:17.19L :28.59Y 2:48.29L fly 2:20.29Y 2:38.79L :24.49Y 2:42.69L 15 & over 200 fly 2:13.39Y 2:30.59L :17.59Y 1:28.99L breast 1:12.09Y 1:21.29L :15.69Y 1:26.69L 15 & over 100 breast 1:08.89Y 1:19.69L * free relay *Open 400 free relay :52.99Y 5:16.59L * free# 5:35.19Y 5:02.79L :32.89Y 4:55.99L *Open 400 free# 5:10.79Y 4:38.09L 62 *Timed finals events; # may be limited to the fastest 4 seeded heats each of men and women in each age group; fastest seeded heat each men and women swum in finals Saturday, June 16, 2012 Session 5: Schedule of Events 12 & Under 45-minute warm-up starts 15 minutes after the end of the AM Session Saturday: prelim/final format GIRLS Qualifying Time Age Group/Stroke Qualifying Time BOYS 63 3:03.79Y 3:29.69L IM 3:03.79Y 3:29.69L :42.69Y 4:12.99L 10 & UN 200 IM 3:42.69Y 4:12.99L free & UN 100 free :04.99Y 3:29.09L * fly 3:04.99Y 3:29.09L fly & UN 50 fly back & UN 100 back * Free Relay 82 *Timed final events Session 6 Saturday Finals will not begin before 6:00 PM after a 45-minute warm-up. Finals Order of Events: 43,44,45,46,63,64,65,66,47,48,49,50,67,68,69,70,51,52,53,54,73,74,75,76, 59,60,61,62, 77,78,79,80 6

7 The Robert F. Busbey Invitational Meet Sunday, June 17, 2012 Session 7: Schedule of Events 13 & Over Timed Finals 45-minute warm-up starts at 7:30AM; Meet starts 8:20AM Sunday: timed finals all events GIRLS Qualifying Time Age Group/Stroke Qualifying Time BOYS 83 OPEN 800 free relay :07.79Y 1:16.49L fly 1:02.89Y 1:11.09L :06.29Y 1:14.19L 15 & over 100 fly 1:00.09Y 1:07.69L :17.79Y 6:00.99L IM 5:00.49Y 5:44.49L :56.99Y 5:35.99L 15 & Over 400 IM 4:35.79Y 5:13.49L Y 32.49L free 26.29Y 30.29L Y 31.79L 15 & Over 50 free 25.29Y 28.79L :08.49Y 1:17.79L back 1:04.19Y 1:14.49L :06.59Y 1:16.29L 15 & Over 100 back 1:01.09Y 1:10.59L :25.99Y 10:10.59L Open 800 free# 10:44.19Y 9:36.89L 102 # may be limited to the fastest 2 seeded heats of each men and women with the fastest heats swimming first, alternating women and men Sunday, June 17, 2012 Session 8: Schedule of Events 12 & Under Timed Finals 45-minute warm-up starts 15 minutes after the end of the AM Session Sunday: timed finals all events GIRLS Qualifying Time Age Group/Stroke Qualifying Time BOYS breast & UN 100 breast back & UN 50 back :01.89Y 3:30.29L back 3:01.89Y 3:30.29L & UN 100 fly fly & UN 200 med relay med relay :40.09Y 6:00.09L 12 & Un 400 free* 6:40.09Y 6:00.09L 122 *may be limited to the fastest 2 seeded heats each of men and women and will not be scored separately by age groups 7

8 LAKE ERIE SWIMMING, INC. INDIVIDUAL AND RELAY SCRATCH RULE Each swimmer/relay team shall be aware of the meet starting time and shall report to the proper meet authorities promptly upon call. A. Pre-Seeded Meets - Each swimmer/relay team shall report promptly to the Clerk of Course or starting blocks prior to the race in which the swimmer/relay team is entered. Any swimmer/relay team not reporting for or competing shall not be penalized. B. Events Seeded on the Deck (1) Events seeded on the deck shall be closed for seeding no earlier than thirty (30) minutes prior to the start of the session. Host may provide alternate methods of check-in (such as , phone, and/or fax) for swimmers who do not plan to arrive before the scratch deadline. (2) Any swimmer who has checked in for an individual event 400 yards/meters or longer must swim in the event unless the swimmer notifies the Clerk of Course or Administrative Official before the seeding of the event has begun that the swimmer wishes to scratch; failure to scratch prior to seeding and not swimming the event will result in a fine of $25.00 to the swimmer, except as noted in "Exceptions for Failure to Compete" (below). A declared false start or deliberate delay of the meet in events 400 yards/meters or longer is not permitted and will be regarded as a failure to compete. (3) Any agent of a team (coach, parent, swimmer, etc.) who checks in a swimmer for any event when that swimmer is not present at the meet may cause a fine of $2.00 per swimmer per day to be levied against that team. (4) Events seeded on the deck and swum as a timed final with one or more heats swimming with finals shall provide the swimmer the opportunity to indicate their desire to swim only during the preliminary session by indicating this desire by placing a P next to their name on the sign in sheet. Any swimmer failing to indicate this desire who does not compete during the finals session shall be subject to a fine of $25.00, except as noted in "Exceptions for Failure to Compete" (below). C. Scratching from Bonus Finals, Consolation Finals, and Finals (1) Any swimmer qualifying for C, B, or A (bonus, consolation, or final race) in an individual event who fails to compete in said race shall be barred from further competition for the remainder of the meet, except as noted below in "Exceptions for Failure to Compete." If such failure to compete occurs on the swimmer's last day of the meet, the swimmer s club shall be fined twenty-five dollars ($25.00) by LESI. If the swimmer is not a member of a USA Swimming member club, the swimmer shall be fined $ A declared false start or deliberate delay of the meet is not permitted and will be regarded as a failure to compete. (2) In the event of withdrawal or barring of a swimmer from competition, the Referee shall fill the consolation final or final when possible with the next qualified swimmer(s). First and second alternates shall be announced along with the final qualifiers. These alternates shall not be penalized if unavailable to compete in the finals. (3) When consolation finals have not yet been swum and a barring or withdrawal is known to the Referee, the Referee shall re-seed the consolation final and the final, if necessary, to insert the alternate(s) in the appropriate lane(s), filling all lanes in the final. (4) If a consolation final has already been contested, the final shall be swum without reseeding for the empty lane(s). D. Exceptions for Failure to Compete - No penalty shall apply for failure to withdraw or compete in an individual event if (1) The Referee is notified in the event of illness or injury and accepts the proof thereof. (2) A swimmer qualifying for a consolation final or final race following preliminaries notifies the Referee or designee within thirty (30) minutes after the announcement of the qualifiers for that race that the swimmer may not intend to compete. The swimmer must declare within thirty (30) minutes following his last individual preliminary event a final intention to scratch or swim. (3) The Referee determines that failure to compete is caused by circumstances beyond the control of the swimmer. 8

9 2012 Robert F. Busbey Meet Entry Sheets GIRLS TEAM CODE NAME AGE USA SWIMMING # EVENT# TIMES (meters/yds) BOYS TEAM CODE NAME AGE USA SWIMMING # EVENT # TIMES (meters/yds) 9

10 The Robert F. Busbey Invitational Meet June 15-17, 2012 ENTRY SUMMARY SHEET TEAM: PREFERRED TEAM CODE (up to 4 letters) (YOUR LSC 2-LETTER CODE ( LE, OH, MI, AM, etc.) TEAM CONTACT NAME: Team Contact PHONE #: DAY: / EVENING: / HEAD COACH: (Total# of swimmers) X $2.00 (LE Surcharge) = (Total# of swimmers) X $1.00 (Paper entry Surcharge) = (Total# of individual events) X $5.00/event = (Total# of relay events) X $10.00/relay entry = TOTAL AMOUNT REMITTED $ $ $ $ $ For Hospitality purposes Total # 0f coaches attending AM Sessions Total # 0f coaches attending PM Sessions Swimmers will be without a coach on deck: Fri. sessions Sat. sessions Sun. sessions 1 2 I have arranged for my swimmer/s to be supervised by. I VERIFY THAT EVERY SWIMMER LISTED ON THE ENCLOSED ENTRY FORM IS A REGISTERED ATHLETE MEMBER OF USA SWIMMING, AND THAT EVERY COACH REPRESENTING OUR TEAM WILL BE A CURRENT COACH MEMBER OF USA SWIMMING. SIGNED: (coach or team representative). DATE: Make checks payable to SPIRE INSTITUTE and mail to: Beth Forsythe, 4977 Countryside Road, Lyndhurst, Ohio 44124; lesdbusbeyentries@gmail.com. Please note all entries submitted with this sheet should be covered by a single check. Deadline for receipt is June 4, This sheet must accompany all entries, including HY-TEK Meet Manager electronic entries. Final results to: 10

11 Cleveland State University Release and Waiver of Liability As consideration for my participation in the Busbey Meet (the "event") I hereby for myself, family, heirs, executors, administrators and assigns waive, release and forever discharge Cleveland State University and its Board of Trustees, officers, employees and agents from any and all liabilities, demands, claims, damages, losses, costs (including attorney's fees), actions and causes of action arising out of or in connection with my participation in the above listed event and/or the use of Cleveland State University facilities, furnishings, or equipment during this event, except to the extent such liabilities, demands, claims, damages, losses, costs (excluding attorney's fees), actions and causes of action are attributable to the negligent actions of Cleveland State University or its Trustees, officers, employees, or agents while acting within the course of their employment, as set forth in Ohio Revised Code Section I also acknowledge that Cleveland State University and its Trustees, officers, employees and agents assume no responsibility for any bodily injury, death, loss, illness or accident to myself or others or damage to personal property which may arise out of my participation in this event. I fully understand and hereby acknowledge that participation in this event involves many risks, including the risks of serious bodily injury and death. In consideration of being allowed to participate in the event listed above, I voluntarily accept and assume all responsibility for and risk of such personal injury arising from such participation. I understand that any University personnel or agents participating in this event are not necessarily medically trained to care for any physical or medical problems that may occur during this event. I release all such personnel from any claim whatsoever on account of first aid or service rendered to me during my participation in this event. By placing my signature below, I acknowledge that I have adequate medical and hospitalization insurance for any injuries that I may incur as a result of participating in this event. I attest and verify that I am 18 years of age or older, that I have had a recent physical examination and that I have no known health problems or conditions that could prevent me from successfully participating in this activity. IF APPLICANT IS LESS THAN 18 YEARS OF AGE, THE PARENT'S CONSENT, RELEASE AND WAIVER OF LIABILITY ON THE BACK OF THIS FORM MUST ALSO BE COMPLETED AND SIGNED. Participant's Name (Please print) Participant's Phone Participant's Address I have read and fully understand the entire RELEASE AND WAIVER OF LIABILITY and my signature below confirms my full understanding and voluntary acceptance of such RELEASE AND WAIVER OF LIABILITY. Participant's Signature Date 11

12 Cleveland State University Parent's Consent, Release and Waiver of Liability IF APPLICANT IS LESS THAN 18 YEARS OF AGE, BOTH SIDES OF THIS FORM MUST BE COMPLETED AND SIGNED. I hereby give my consent for my minor child, to participate in The Busbey Meet (the "event"). If my child becomes ill or is injured while participating in this event, please contact either of the following: Daytime Name Phone ( ) Name Phone ( ) Evening Name Phone ( ) Name Phone ( ) In the event that reasonable attempts to contact the above-mentioned persons are unsuccessful or impractical, I hereby give my consent for emergency medical treatment to be administered to my child and/ or the transfer of my child to a treatment facility. I also release all such personnel from any claim whatsoever on account of first aid or service rendered to my child during participation in the event listed above. I have read and fully understand the entire RELEASE AND WAIVER OF LIABILITY, including the paragraph relating to no known health problems or conditions and my consent to emergency treatment. In consideration for my child 's participation in the event listed above, I do hereby agree to assume all the risks and responsibilities surrounding such participation and do hereby also for and on behalf of myself, my minor child, my heirs, executors, administrators and assigns waive, release and forever discharge Cleveland State University, its Board of Trustees, officers, employees, and agents from any and all liabilities, demands, claims, damages, losses, costs (including attorney's fees), actions and causes of action arising out of my child's participation in this event. Parent's/Legal Guardian's Signature Date ( ) Parent's/Legal Guardian's Name (please print) Parent's/Legal Guardian's Phone Parent's/Legal Guardian's Address 12