SAOP Race 1, 2021 (Metro Coast - AORS Race 5)

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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 2021 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    Gender -- Male Female   Surf Lifesaving Club name Choose one None Non-SA Club Aldinga Bay Brighton Chiton Rocks Christies Beach Glenelg Goolwa Grange Henley Moana Normanville North Haven Port Elliot Port Noarlunga Seacliff Semaphore Somerton South Port West Beach Other     Craft Type Choose one Ocean Ski SLS Spec Ski Double (Ocean or SLS Spec) SUP OC1 Prone Paddleboard Other     Phone #   Emergency contact name   Emergency phone #   Category Choose one 18yrs and under Male 18yrs and under Female 23yrs and under Male 23 yrs and under Female Open Male Open Female Open Mixed (all ages) 40-49 Male 40-49 Female 50-59 Male 50-59 Female 60-69 Male 60-69 Female 70+ Male   Event entry fee 30.00 AUD

Please review the waiver provided by the event organizer and click the check box below to accept it. Print waiver I hereby acknowledge and agree that: 1. I am at least 16 years of as of 00:00 October 01, 2021. 2. I am a financial member of a Surf Lifesaving Club within Australia and holding a proficient Bronze Medallion award as of the date of the race. 3. Ocean paddling can be dangerous. I acknowledge that I may be exposed to certain risks during the event including but not limited to physical exertion, contact with other craft, and surf, sea and weather conditions. 4. I agree to wear/carry all mandatory safety equipment including: . a. PFD meeting the Australian standards AS 4578 Level 50 (type 2) . b. Leg Rope . c. Mobile Phone with SafeTrx App (actively tracking me) . d. Adequate Hydration . e. Hi-Visibility Hat . f. Hi-Visibility Rash top (mandatory if your PFD is not Hi-Visibility) . g. Pealess Whistle 5. I am physically fit and have adequately trained for this event. By the date of the event, I will have completed the distance in a single training session. 6. I am able to swim continuously for 400 metres in turbulent open water unaided. 7. I have been assessed by a medical practitioner as being physically capable of successfully completing the event. 8. I hereby consent to receive any medical attention, including ambulance that may be deemed to be necessary in the event of injury or illness. The cost of such action will be met by me. 9. My image may be used by organisers for any promotional use. 10. I have read, understood, and agree to the race rules as published on the event website. I, the undersigned in consideration of and as a condition of acceptance of my entry, myself, my heirs, executors and administrators waive all and any claims, rights and causes of action of whatever nature, which I or they might otherwise have, arising out of injury, loss of life or loss or damage to my material possessions, which I may sustain consequent upon my entry or participation in the said event. I accept the terms of the waiver Name of parent or guardian who approves this activity