MVH Lavender Patch Swim Waiver
MEYNALL VALLEY TRIATHLON CLUB (MVH) - HALL CROFT FARM
CONSENT FORM 2021 – TO BE COMPLETED BY ANYONE SWIMMING AT THE LAKE
Email *
Name *
Email *
Home Address *
Phone number *
Emergency Contact Name *
Emergency Contact Telephone Number *
Please state any allergies *
Please state any medical conditions *
I understand that if I wish to swim without a wet suit I must swim with a tow float regardless of competence. *
Required
I agree to only swim wearing a wetsuit specifically designed for Open Water Swimming *
Required
I agree that if I am a junior under 18 I will swim with a tow float regardless of competence. *
Required
I agree to liaise with the registration desk if I am participating in Swim/Run during my session at the lake. *
Required
I agree to the following Terms and conditions for swimming at the lake 1. I am over the age of 14 years. (As a BTF affiliated club and in line with BTF guidelines a minimum age of 8 in the current year is permitted on the basis that the young person is accompanied (side by side) throughout the swim by an experienced open water adult swimmer) 2. I am a competent swimmer capable of completing a 500 meter continuous swim. 3. A swim wetsuit and brightly coloured swim hat are to be worn at all times whilst in the water. I will refer to a club official to ensure the British Triathlon open water swimming guide is followed regarding permissible non wetsuit swim water temperature combined with my intended swim distance. Any non wet swimmers are required to swim with a swim float attached. 4. Any minors (under the age of 18) are required to swim with a swim float attached. 5. I will register my name with the official club registration desk and receive a number marked on the back of my hand for emergency identification purposes before entering the water. YOU MUST check out of the water with registration after your swim is complete. 6. I acknowledge club officials, registration members and spotters with swim session duties will be identifiable by provision of a hi-vis vest, they are in place for my safety and I will adhere to the instruction and information they provide at all times in the interests of safety. I accept a club official, the registrar or spotter have the right to refuse entry to any swimmer. 7. I will provide the appropriate contact details in the event of emergency and agree these can be kept on record by MVH Tri Club use only. 8. I agree to take full responsibility for my belongings whilst within the grounds of the lake and take away any litter. 9. I shall ensure that my family/friends not swimming but accompanying me are aware that they must not stand within 2 meters of the water’s edge unless they are wearing a life jacket or buoyancy device, and at must at all times behave appropriately 10. I shall ensure that I have paid the club the appropriate fee before entering the water. 11. I will not enter the water until I am instructed all safety measures have been put in place and will abide by such safety measures at all times ensuring I swim within the designated area as defined by the positioned buoys. 12. I will exit the water when instructed or at the end of the designated swim session, and in any event report to the registrar when exiting the water. 13. I will make a ‘duty’ club member aware of any breaches of the rules set out below or any unsafe conduct coming to my attention. 14. On duty club officials, registration or spotters may at any time in response to an emergency situation immediately implement the EMERGENCY ACTION PLAN (EAP). The signal for an emergency is the continuous sounding of an air horn. Upon hearing the air horn swim toward the nearest bank and lake side to shallow water, stand up and look around you, remain alert, observe the signals and instructions of on duty club officials. Should the EAP be implemented you must not leave the site until your safety is validated by a club official and you have checked out with registration. 15. On duty club officials, registration or spotters may at any time summons the attention of swimmers by repeatedly blowing the safety whistle. Observe the signals and instructions of on duty club officials. 16. If having agreed with a MVH Tri Club official, to swim as a pair (as an example - an experienced open water swimmer and a novice open water swimmer) I will swim as a paired swimmer during the whole of my time in the water. 17. I will enter and exit the water at the specified place and stay within the designated swim route unless instructed otherwise by a club official. 18. I shall not swim or enter the water if feeling unwell, and in the event I get into difficulty during the swim session I shall roll on to my back and signal for rescue by raising either my left or right arm in the air. 19. I shall ensure all children are appropriately supervised at all times and are kept away from the water’s edge and any wildlife or horses within the lake area. I understand Hall Croft Farm is a working farm and it is not permissible for children to play around the fields freely and other areas of the farm. 20. Pets must be on a lead at all times. 21. I agree to abide by the 10mph speed limit whilst on site and will give priority right of way to cars arriving at the site. 22. I accept that MVH Triathlon Club, the lake owners and their agents will not accept any liability for loss, damage or injury to persons or property howsoever caused. 23. I acknowledge it is my responsibility to have the correct insurance to cover against any injuries or losses I may incur whilst within the grounds of the lake or sounding areas including the lake, any car park or entering/exiting the grounds of the farm/lake by any means. 24. I acknowledge my legal responsibility to not put myself or others at risk due to my own actions or omissions. I confirm that I have no known medical conditions that would prevent me from undertaking open water swimming. *
I agree that as a pre-requisite to Open Water swimming with MVH Triathlon Club I am required to read and accept this agreement to abide by the strict safety measures and code of conduct of MVH Triathlon Club each year and I understand I will not be allowed to enter the water until a signed waiver has been correctly completed and accepted by a club official. *
Required
I agree to abide by the safety measures herein and any instructions issued by a club official and any other local safety requirements issued on the day of the swim. I am fully aware of the dangers of swimming in an open water environment and the fitness levels required and I accept that MVH Triathlon Club, landowners and their agents cannot be held responsible for any loss damage or injury to persons or property howsoever caused. Complete your name below to agree. *
A copy of your responses will be emailed to the address you provided.
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