Dosthill Quarry Swim Registration

Contact

Required Email

Required First name

Required Last name

Required Gender MaleFemale

Required Date of birth (dd/mm/yyyy)

Required City or town

Required Post code

Required Mobile Phone

Home Phone

Swimming status

Required I can swim

Required I can swim the following metres in a pool or open water

Optional Swimming Club (or leave blank)

Optional National Swimming Association (or leave blank)

Required Pre-existing medical condition including medication and/or sensitivity to particular drugs (or enter None)

Optional Do you want to swim with your dog(s)YESNO

Terms and conditions

Liability Release and Express Assumption of Risk
This liability release may be used as evidence in a court of law if you decide to sue any released party or person. Please read this document.
I, the above-named swimmer, hereby agree that I have been fully advised and completely informed of the inherent risks and hazards associated with open water swimming.
I, further, completely understand that open water swimming involves certain inherent risks and hazards to include: hypoxia, asphyxia, hypothermia and drowning. These maladies may result in permanent injury or even death. By signing this document I evidence that I am fully appraised of the risks and hazards associated with the type of activity that I am contemplating and I expressly assume these risks. I, further fully understand that my swimming activity may be conducted in point of time and distance in a remote location not readily accessible to first aid and rescue facilities. Nevertheless, I still choose to proceed with the activity despite the possible lack of medical facilities to assist me should I become injured.
I fully understand and agree that the Dosthill Quarry centre through which I participate in the activity, nor the owner of Dosthill Quarry, Ian Forster, nor any of his respective employees, officers, agents or assigns, may be held liable or responsible in any fashion for any injury, death or damages to me or my family, heirs or assigns that may occur as a result of my participation in this open water swimming activity or as a result of active or passive negligence of any party including the released parties named in this document.
In exchange for me being allowed to enrol and participate in this activity I hereby personally assume all risks in conjunction or connection with this activity or any harm or injury or damages that may befall me, my heirs or assigns while participating in this activity. I specifically assume all risks associated with my participation in this activity whether foreseen or unforeseen.
In consideration for my participation in this activity I save and hold harmless and agree to indemnify the Dosthill Quarry centre at which I am participating in an open water swimming activity, and the owner of Dosthill Quarry, Ian Forster, of any claim or lawsuit brought by me, my family, my estate, my heirs or assigns arising out of or in connection or in conjunction with participation in this activity including both claims arising during or after the activity, and it is my express intention to release the parties cited from all liability and responsibility whatsoever for personal injury, property damage or wrongful death however caused.
I also understand fully that open water swimming activities are physically strenuous, and that they require specialized training. I also understand that I will be physically exerting myself during this activity and that should I become injured as a result of a heart attack, failure to control my panic, failure to control my breathing or hyperventilation, I specifically assume the risk of any resulting injuries and in exchange for my participation in this activity I expressly agree that I will not hold the released individuals in this document responsible.
By submitting this document online, and by signing it on my first subsequent visit to the lake, I evidence that I have fully read, contemplated, and understand the contents of this liability release and express assumption of risk, and release my right to sue. I agree to the terms and conditions of this document in exchange for my participation in this activity. I further state that I am of lawful age and legally competent to sign this release or that I have acquired the specific written consent of my parent or guardian.
I understand that this document constitutes a contract between myself and the released parties cited.
Under 18?

Applicable? Name

Applicable? Relationship —Please choose an option—FatherMotherGuardian

Over 18?

Required I am 18 or older andI accept and agree to all terms

PLEASE READ THE 3 IMPORTANT STEPS BELOW TO AVOID MULTIPLE ENTRIES OF YOUR REGISTRATION FORM!!

If you have completed all the required fields, and ticked the required boxes above, then when you press the send button, you should receive a message below it, "WHEN YOU PRESS THE SEND BUTTON, YOU SHOULD RECEIVE A MESSAGE BELOW IT, "YOUR SWIM REGISTRATION WAS SENT SUCCESSFULLY TO DOSTHILL QUARRY. YOU WON'T RECEIVE AN EMAIL COPY BUT PLEASE ACCEPT THAT YOUR REGISTRATION WAS SENT SUCCESSFULLY, DON'T RESUBMIT IT, AND PLEASE DON'T CALL DOSTHILL QUARRY.".

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