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OPEN WATER SWIM DECLARATION AND INDEMNITY

 

Name

 

 

Address

 

 

 

 

Contact Telephone

 

 

Email Address

 

 

Please tick here ……….if you do not wish us to contact you via e-mail. 

We will not pass on any information to 3rd parties.

 

Next of Kin

(Emergency contact

name and number)

 

 

 

Medical Conditions

 

 

 

Open Water Swim

Experience

 

Please tick:

Novice………….

Intermediate………..

Experienced……….

 

 

This indemnity clause is to cover all open water swimming activity organised by Runaround Sports with Top Barn Activity Centre for the open water season. By signing this agreement the swimmer also agrees to conform to any reasonable changes to the schedule that may occur due to unforeseen difficulties.

 

For Health and Safety reasons the swimmer also agrees to “sign in and out” of the water.

 

INDEMNITY CLAUSE

 

I acknowledge, to the best of my ability, that I am in good health and have no known medical problems that would restrict my ability to participate in open water swimming. I recognise that participation in physical activity involves the risk if injury, to my person or property.  I acknowledge that whilst I participate, I do so at my own risk.

I will not hold Runaround Sports or Top Barn Activity Centre, their instructors, members, servants or agents liable for any personal injury, loss of property which I may suffer whether caused by the negligence or omission of any of the above.

 

 

Signed:

 

Date:

 

To assist us on arrival on your first swim session please print out this waiver, complete it and hand it in to a member of staff on your arrival.

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