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Mercer Island Marathon Swim

solo application

 
Personal info
Name *
Name
Birthdate *
Birthdate
Cell phone *
Cell phone
(Something you'll bring with you the day of the swim.)
Home address *
Home address
Swimmer qualifications and details
Open water swim pace, indicate .
Must include at least one swim over 10k. List only swim events.
Past marathon swimming service, including crew, observing, paddling, or other service.
Describe your anticipated feed plan for this swim.
What else should be considered?
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.
Fees *
You are not required to pay anything now. If selected, you will be notified by email and given payment instructions. 25% of the registration fee will be due before 1 March 2018 and is not refundable. The balance is due by 1 May 2018 and is not refundable within 30 days of the swim date.