Bolton Triathlon Club - Open Water Swimming Membership & Consent Form 2018
Event Timing: Tuesdays 5 to 8pm from 15th May to 28th August 2018.
Event Address: Elton Sailing Club, off Buller Street, Bury, BL8 2BR
Surname *
Your answer
First Name
Your answer
Age *
Your answer
Email *
Your answer
Postcode *
Your answer
Tel No. (mobile preferred) *
Your answer
Emergency Contact Details - Name *
Your answer
Emergency Contact Details - Tel No. *
Your answer
Emergency Contact Details - Relationship to swimmer *
Your answer
Details of any medical conditions/injuries/disabilities that may affect your safe participation in open water swimming and/or any safety measures that need to be taken e.g. asthma and having inhaler accessible, impaired hearing etc. *
Your answer
Disclaimer: by agreeing to this disclaimer you are accepting on your behalf, or on behalf of your son or daughter if under 18, that you or they are taking part in Open Water swim sessions of your/their own free will, knowing that the session will have safety cover in place. That you are happy to take responsibility for your/their actions in swimming in open water and that Bolton Triathlon Club cannot be held responsible for any illness, accidents, injury or death. You are also agreeing that you/they are a competent swimmer and able to swim 500m without stopping. *
Parental/Guardian Consent for swimmers under 18 years old. I give permission for my son/daughter to participate in open water swim coaching sessions. I understand and agree that my son/daughter participates in these sessions entirely at his/her own risk. I am satisfied that he/she is sufficiently responsible and competent to take responsibility for his/her own safety.
Are you a member of any clubs? If so, which?
Your answer
Are you competent on a sit on top kayak and willing to provide safety cover in return for a free swim per hour of safety cover?
On my first visit I agree to pay £3 to register with Bolton Tri Club as an open water swim member unless I am already a BTC full member?
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