Mercer Island Marathon Swim

PADDLER Info Sheet

Personal info

Name

First Name

Last Name

Birthdate

YYYY

Email address

Cell phone

(Something you'll bring with you the day of the swim.)

(###)

###

####

Home address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Swimmer's name

If you are paddling for a specific swimmer, enter their name. If you are not, leave this blank.

Vessel details and paddling experience

Vessel description

Type, color, length, etc. If renting, type 'rental.'

Paddling experience

Include a brief description of your abilities and experience paddling. Have you ever paddled for a swimmer before?

Swimming experience

Are you an open water swimmer? Have you spent time swimming next to a paddler?

Other info

What else should we be aware of? What questions or comments do you have?

Emergency information

Do NOT list your swimmer as your emergency contact.

Emergency contact

First Name

Last Name

Emergency contact phone

(###)

###

####

Medical

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.

I have read and agree to the above Waiver.

Event understanding

I understand that 1) I will be assigned to a swimmer, and will be that swimmer's eyes and ears, navigator, and emotional support, 2) the swim may last up to 9 hours, and that I may not get a bathroom break, 3) my swimmer will be counting on me, and being unprepared or unable to perform my duties may result in the swimmer being disqualified from the event, 4) my swimmer and the event organizer will be counting on me to make good judgement calls about the health and safety of my swimmer, 5) that additional information will be provided, and that I should ask any and all questions about my responsibilities before the day of the event.

I understand the demands of this event.