NOWSA Solo Swim

Escort boat & Pilot INFO Sheet

Event date *
Event date
or first date in window

Pilot info

Name *
Name
Birthdate *
Birthdate
Cell phone *
Cell phone
(Something you'll bring with you the day of the swim.)
Home address *
Home address

Vessel details and experience

Our insurance requires vessels to be under 51 feet.
Make, model, engine, HP
Per your vessel's capacity plate
Type I, II, and III only
Miscellaneous safety and comfort gear
Include a brief description of your abilities and experience. Any special training or licenses?
Are you an open water swimmer? Have you spent time swimming next to a boat?
What else should we be aware of?

Emergency information

Emergency contact *
Emergency contact
Emergency contact phone *
Emergency contact phone
This will not be used to evaluate your application.

Agreement

Waiver *
Liability Release: As a condition of participating in the Mercer Island Marathon Swim, I agree to attend the mandatory briefing the morning before the start of the event, and will abide by the event rules and regulations including water safety determinations. On behalf of myself and my heirs, and intending to be legally bound, I hereby certify that I am physically fit and have not been otherwise informed by a physician. I acknowledge that I am aware of the risks inherent in participating in open water swimming events and in training for same, including permanent disability and death, and agree to assume all of those risks. AS A CONDITION OF MY PARTICIPATION IN THE MERCER ISLAND MARATHON SWIM AND ANY ACTIVITIES INCIDENT THERETO, I HEREBY WAIVE ANY AND ALL RIGHTS TO CLAIMS FOR LOSS OR DAMAGES TO MY PERSON OR PROPERTY, INCLUDING ALL CLAIMS FOR LOSS OR DAMAGES CAUSED BY NEGLIGENCE, ACTIVE OR PASSIVE, OF ANY OF THE FOLLOWING: HOST FACILITIES, NOWSA (NORTHWEST OPEN WATER SWIMMING ASSOC, INC), EVENT SPONSORS, EVENT COMMITTEES, VOLUNTEERS, AND ANY INDIVIDUALS OFFICIATING, SUPERVISING AND/OR OTHERWISE INVOLVED IN CONDUCTING THIS EVENT.
Event understanding *
I have been selected by my swimmer to accompany him/her during the swim. I understand that I will be responsible for the safety of the swimmer and crew, navigation, and logistics before, during, and after the swim. A NOWSA observer will be on board during the swim to provide documentation only.