ISLE OF WIGHT MARLINS SWIM CLUB in association with SHANKLIN TOWN REGATTA

SANDOWN TO SHANKLIN SEA SWIM 2015

Saturday August 15th with a 1pmStart - DistanceApproximately 1.8 miles

ENTRY FORM FOR 2015
*FREESTYLE (please circle choice!!!!!!) *BREASTSTROKE
Female/Male (please circle!)
Full name : / Address :
Post Code :
Telephone No : / Mobile No : / *Email :
*Full results will be posted on the website the day after the swim.
Date of Birth / Age (As At Date Of Swim) / Club Name / unattached:
This year we are again going to number hats, therefore they will be plain coloured latex hats. However if you wish to purchase a silicone commemorative hat (which will be plain in colour and have a logo and swim year details etc) then please circle yes/no and enclose an additional £5.00
Please note: only members of the British Long Distance Swimming Association are covered for personal injury risks for this swim. All other competitors take part entirely at their own risk. Personal accident insurance included with Amateur Swimming Association will not apply as this is not an ASA event. However non BLDSA members can purchase temporary membership for the day for a cost of £5 and this would then cover them for personal injury. If you would like to take advantage of this offer please add this amount to your entry fee cheque. If you do not wish to take up this offer but would still like cover for the day you are advised to make or review your own arrangements.
Declaration :I, the undersigned, declare that I am over 18 years of age, can swim a minimum of 2 miles in open, deep water sea conditions and am confident in my ability to complete the swim. I undertake to compete in this event at my own risk and fully understand that the organisers will not be held responsible for any injury (including death), illness, or accident to my person, or loss of property resulting from any cause whatsoever. I have not been informed by any medical practitioner and I have no knowledge of any medical condition which would make it inadvisable for me to compete in this event. I will attend the briefing meeting prior to the start of the swim and will thoroughly read the safety information given to me at registration. I further guarantee that the information I have provided above is correct.
Signed : Date:
TEAMS : 4 swimmers’ names and team name (may also be submitted on the day)
The organisation and timing of this event shall be under the direct control of the Isle of Wight Marlins’ Swim Club Organisers and their decision will be final in all matters.
Entry Fee of £24.00 (In the event of any kind of cancellation on the day a partial refund will be made).
Make Your Cheque payable to IOWMSC. Please return it with this Entry Form to:
Lindsey Shenton. 12 The Glade, Wroxall, Ventnor, I.O.W. PO38 3QA
Tel :01983 852625 Email :
STRICT CLOSING DATE : 7th August2014 .
OR earlier if support boat limit is reached. Late entries only accepted if numbers allow.