Relay Team Swimmer Application

Transcription

1 The St. Vincent s SWIM Across the Sound Marathon Saturday, August 1, 2009 Captain s Cove Marina Bridgeport, CT Relay Team Swimmer Application Sponsored by: St. Vincent s Medical Center Foundation (203)

2 SWIM MARATHON RULES & GUIDELINES RELAY TEAM SWIMMERS 1. CLOTHING: Relay swimmers are permitted to wear wetsuits. Swimmer must wear event swim cap while in the water. 2. ASSISTANCE: Swimmers may not use flotation aids, propulsion devices, or any other devices to maintain body heat. Fins, hand paddles, pull buoys or boards are strictly prohibited. Pacing, drafting and towing are not allowed. Swimmers may not touch the escort boat or any other boat during the event. A violation of this rule shall result in disqualification. Swimmers are required to bring their own food for the swim. The use of alcohol or drugs is strictly forbidden. 3. QUALIFYING SWIM: No qualifying swim is required. It is strongly recommended that all relay team members gain experience swimming in open water prior to participation. 4. AGE MINIMUM: Relay team members must be 13 years old on or before December 31 of the year of the event, in accordance with FINA Age Rules. 5. RELAY INSTRUCTIONS: A minimum of 4 and maximum of 6 relay swimmers per team. Swimmers must alternate every minutes (no exceptions). Failure to follow this rule will result in disqualification. The order of the swimmers must be maintained throughout the swim. The transition from one swimmer to the next must be executed by approaching the swimmer in the water from behind, and the transition is considered complete when the entering swimmer fully passes the departing swimmer. Additional crew or helpers outside of relay team members are not permitted on the escort boat due to space limitations and safety reasons. Relay team members must enter the water feet first. Failure to follow this rule will result in disqualification. Team Relay Application - Page 1 of 6

3 RELAY TEAM APPLICATION TEAM INFORMATION (To be completed by Team Captain.) Please Note: Use full legal names (no nicknames or abbreviations). Team Name: Team Captain or Coach Name: Captain/Coach Phone: Captain/Coach Swimmer #1 Age*: Swimmer #2 Age*: Swimmer #3 Age*: Swimmer #4 Age*: Swimmer #5 Age*: Swimmer #6 Age*: In order to keep the flow of information consistent and accurate, any questions or information needs by team members should be communicated by the Captain or Coach to the Race Committee. Are you representing a club, organization or corporation? If Yes, please explain! Acknowledgement of Captain/Coach of Team I acknowledge and understand that competing in such an event is an extreme test of each team member s swimming ability, mental toughness and physical conditioning. I have selected the team members with these conditions in mind and believe that each team member is physically fit and capable of swimming in this event. I also acknowledge that the fundraising goal for the team is $7,500 and that the team is committed to reaching and hopefully exceeding this goal. Team Captain Date *Day of Race Team Relay Application - Page 2 of 6

4 TEAM MEMBER APPLICATION PLEASE NOTE: USE FULL LEGAL NAMES (NO NICKNAMES OR ABBREVIATIONS). Team Name: Team Captain or Coach Name: Full Legal Name: Address: City, State, Zip, Country Home Phone: PERSONAL INFORMATION Cell Phone: Contact Gender: DOB: (mm/dd/yy) Age: T-shirt size: Height: Weight: Please note: your name, age, hometown and background information may be used for media relations and promotional purposes. Your contact information may be used to reach you for media inquiries, but will never be published without your granted consent. WORK INFORMATION Occupation & Title: Employer: Employer Address: City, State, Zip Country Phone: Fax: Does Your Employer Match Charitable Donations? Yes No Name: Home Phone: EMERGENCY CONTACT INFORMATION Relationship: Cell Phone: Team Relay Application - Page 3 of 6

5 TEAM MEMBER APPLICATION ACCIDENT AND RELEASE OF LIABILITY WAIVER I acknowledge that this 25km athletic event is an extreme test of a person s physical and mental limits and hereby certify that I am physically fit and have not been otherwise informed by a physician. I acknowledge that I am aware of all of the risks inherent in Open Water Swimming (training and competition), including possible permanent disability or death, and agree to assume all those risks. I acknowledge that this Accident and Release of Liability Waiver will be used by the event holders, sponsors and organizers of the event of the SWIM Across the Sound, and that it will govern my actions and responsibilities at such event. AS A CONDITION OF MY PARTICIPATION IN THE SWIM ACROSS THE SOUND OR ANY ACTIVITIES INCIDENT THERETO, I HEREBY WAIVE ANY AND ALL RIGHTS TO CLAIMS FOR LOSS OR DAMAGES, INCLUDING ALL CLAIMS FOR LOSS OR DAMAGES CAUSED BY THE NEGLIGENCE, ACTIVE OR PASSIVE, OF THE FOLLOWING: ST. VINCENT S HEALTH SERVICES, ST. VINCENT S MEDICAL CENTER, ST. VINCENT S MEDICAL CENTER FOUNDATION, SWIM ACROSS THE SOUND, CITY OF BRIDGEPORT, CAPTAINS COVE MARINA, DANFORDS MARINA, ALL PARTICIPATING POLICE AND FIRE DEPTS FROM VARIOUS TOWNS, STATES OF CT AND NY, HOST FACILITIES, EVENT SPONSORS, VOLUNTEERS, BOAT CAPTAINS, EVENT COMMITTEES, OR ANY INDIVIDUALS OFFICIATING AT THE EVENTS OR SUPERVISING SUCH ACTIVITIES. In addition, I also agree to abide by and be governed by the rules established by the Race Committee. Finally, I specifically acknowledge that I am aware of all the risks inherent in open water swimming and agree to assume those risks. Print Swimmer s Full Legal Name Age Signature Date If Swimmer is under the Age of 18, Signature of parent or guardian is also required. Print Parent/Guardian Name Age Signature of Parent or Guardian Date Team Relay Application - Page 4 of 6

6 RELAY TEAM MEMBER APPLICATION - PERSONAL STORY Swimmer Full Legal Name: Have you ever participated in the SWIM Across the Sound (SAS)? Yes No If yes, when? What is your personal fundraising goal? (The minimum needed to fundraise by a SAS Relay Team is $7,500) $ What made you interested to participate in SAS? Are you swimming in honor of someone? Any other information you would like to share? Team Relay Application - Page 5 of 6

7 RELAY TEAM MEMBER - SWIMMING BACKGROUND PLEASE NOTE: USE FULL LEGAL NAMES (NO NICKNAMES OR ABBREVIATIONS). Full Legal Name: Team Name: PLEASE LIST SOME OF YOUR MOST RECENT OPEN WATER/POOL EVENTS: (attach documentation) Event Name: Location: Date: Finishing Time: Water Temp: Winner Finish Time: What was your place? Distance: Event Name: Location: Date: Finishing Time: Water Temp: Winner Finish Time: What was your place? Distance: Event Name: Location: Date: Finishing Time: Water Temp: Winner Finish Time: What was your place? Distance: OTHER ATHLETIC ACHIEVEMENTS: OPEN WATER SWIMS PLANNED FOR CURRENT YEAR: Swim #1 Location: Distance: Swim #2 Location: Distance: Swim #3 Location: Distance: PHOTO: Please attach a passport style photo to your application. We may use this for the local media and promotional materials. Team Relay Application - Page 6 of 6