Blue September

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Team name   First name   Last name   Email address   Date of birth DD 01 02 03 04 05 06 07 08 09 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31    MM 01 02 03 04 05 06 07 08 09 10 11 12       YYYY 2020 2019 2018 2017 2016 2015 2014 2013 2012 2011 2010 2009 2008 2007 2006 2005 2004 2003 2002 2001 2000 1999 1998 1997 1996 1995 1994 1993 1992 1991 1990 1989 1988 1987 1986 1985 1984 1983 1982 1981 1980 1979 1978 1977 1976 1975 1974 1973 1972 1971 1970 1969 1968 1967 1966 1965 1964 1963 1962 1961 1960 1959 1958 1957 1956 1955 1954 1953 1952 1951 1950 1949 1948 1947 1946 1945 1944 1943 1942 1941 1940 1939 1938 1937 1936 1935 1934 1933 1932 1931 1930 1929 1928 1927 1926 1925 1924 1923 1922 1921    Gender -- Male Female   Phone #   Emergency contact name   Emergency phone #   Category Choose one 16-19 20-29 30-39 40-49 50-59 60-69 70+ U16   Event entry fee 10.00 NZD

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Please review the waiver provided by the event organizer and click the check box below to accept it. Print waiver Waiver 1. I acknowledge that ocean swimming involves the real risk of serious injury or even death from various causes including overexertion, heart attack, equipment failure, dehydration, hypothermia or accidents with other competitors. 2. I understand that I must not compete in this event unless I have trained appropriately and and I confidently believe that I am sufficiently fit and healthy to compete in this event. 3. By competing, I accept all risks necessarily flowing from my participation which could result in loss of life or permanent injury. Accordingly, I release all persons or corporations associated directly or indirectly with the conduct of the event from all claims demands and proceedings arising out of my participation and I hereby indemnify them against all liability (including liability for their negligence and/or recklessness and the negligence and/or recklessness of others) for all injury, loss or damage arising out of or connected with my participation in this event. This release shall extend to and include volunteers including medical and paramedical personnel appointed for the event, the owners, licensees and occupiers of land upon which the event or any part of it is conducted, any statutory body or local authority having control over any land upon which the event or any part of it is conducted or which is involved directly or indirectly with the event in any manner whatsoever and promoters, sponsors and event organisers. 4. I consent to receiving any medical treatment that the event organisers think desirable during or after the event. 5. I acknowledge that safety precautions undertaken by organisers (such as course supervision, race safety briefing) are a service to me and other competitors but are not a guarantee of safety. I accept that I have an important responsibility to carefully read and listen to all safety briefings and to immediately seek clarification on anything which is not entirely clear to me. 6. I consent to the event organisers using my name, image and likeness before, during or after the event for event promotional broadcasting or reporting purposes in any media. 7. I understand that I am fully responsible for the security of my personal possessions at the event. 8. If the event is cancelled due to poor weather, rough seas or any other condition beyond the control of the organisers, I accept that my entry fee will not be refunded. 9. I agree to my name and contact details being included on the event database of my chosen event(s). (You may unsubscribe from this at any time.) 10. I agree to abide by all race rules and directions issued by the event organiser. 11. I acknowledge that by reason of circumstances beyond the control of the event directors, it may become necessary or desirable to change the format of the event, and if that occurs, I consent to the changes and I agree that each and every of the conditions herein set out shall apply to that changed event. 12. If I am below the age of 16 years I will have these terms and conditions viewed and signed by my legal guardian (on entries taken at a race) or agreed (through the online entry process) which will in effect give consent for me to swim this event. Children under the age of 16 wanting to compete in these events should have a high level of swimming ability and fitness. Parental guidance is required. I accept the terms of the waiver Name of parent or guardian who approves this activity