Please support the event sponsors ENTRY FORM MANDURAH

ENTRY FORM
CONDITIONS OF ENTRY
MANDURAH MASTERS AUSTRALIA DAY OCEAN SWIM
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Entries close at Midnight on Sunday, 25 January 2015.
Entrants must be able to complete the course within 80 minutes.
Only well-prepared and medically fit swimmers should enter.
Wetsuits and/or snorkels may be worn but swimmers will not be eligible for prizes.
Paddles, fins and/or flotation devices must not be used.
Swimmers must not wear heavy jewellery or watches.
Wearing the race cap provided is compulsory throughout the swim.
The event is conducted according to Masters Swimming open water rules.
Mandurah Masters is covered for public liability insurance, however, entrants are
encouraged to have their own personal accident insurance.
10. Late entries will incur an additional fee and the swimmer will not be eligible
for major prizes.
11. Age category awards available to those gaining no other prize (GNOP).
12. Personal support paddlers are not permitted.
13. Participation in the event is voluntary.
14. No refunds will be given in the event the swim is cancelled due to circumstances beyond
the control of the organizers.
15. Attendance at the pre-race brief is compulsory. Swimmers can be penalized for nonattendance.
26 January 2015
SURNAME: ……………………………… FIRST NAME: ……………………….……..
ADDRESS: …………………………….………………………………………….……….
……………………………………………………………………….……….
MALE / FEMALE (please circle)
AGE AS AT 31.12.2015: ….…….… years
DATE OF BIRTH: …..…/…..…/………ESTIMATED SWIM TIME……………..……
EMAIL: ……………………………………..…TELEPHONE………………….…….….
MASTERS CLUB …………………………...(if applicable) MEMBER No. …………….
For the $5.00 HBF discount, my HBF member number No. is……………….………..
Waiver/Declaration of Release from Liability
“Club” for the purposes of this declaration means and includes Mandurah Masters Swimming Inc., and
their directors, officers, members, volunteers, servants or agents.
Warning: Participation in the Event can be inherently dangerous. Serious accidents can happen which
may result in me being injured or even killed.
Exclusion of Liability: Except where provided or required by law and such cannot be excluded, I agree
that it is a term of my entry in the Event (if accepted) that the Event Organizer and the Club are each
absolved from all liability however arising from injury or damage (whether fatal or otherwise) however
caused (including by the negligence of the Event Organizer or the Club) arising out of my participation in
the Event.
Release and Indemnity: In consideration of my application for entry in the Event being accepted I:
(a) release and forever discharge the Event Organizer and the Club from all claims that I may have or
may have had but for this release arising from or in connection with my participation in the Event; and
(b) indemnify and hold harmless the Event Organizer and the club to the extent permitted by law in
respect of any claim by any person including but not only another participant in the Event arising as a
result of or in connection with my participation in the Event.
Photographs: Masters Swimming Western Australia (MSWA) reserves the right to use photographs,
taken either at events or functions, for the purposes of instruction, advertising and promoting MSWA. If
you do not wish your photograph to be used please notify the Event Organizer on registration or the
MSWA office in writing.
I have read, understood, acknowledge and agree to the above declaration including the warning,
exclusion of liability, release and indemnity, and the Conditions of Entry.
Please support the event sponsors
SIGNED: ……………………………………………… DATE: ………/………/……………….
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NOTE: Signature of swimmers aged under 18years must be endorsed by a parent or guardian.
PARENT/GUARDIAN: …………………..………… SIGNATURE: ………….…………..
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Enter on-line at http://mhmannas.tripod.com , www.mswa.asn.au,
or download and post an entry form.
Fees and entry closing dates are as under
For enquiries phone 0427 005 524 or email [email protected]
Mandurah Masters
Australia Day
Ocean Swim
This swim supported by:
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Mandurah Water Rescue Group
Kayaks 4 You, Mandurah
St John Ambulance
Mandurah Paddling Club
Surf Life Saving WA
2km
Doddi’s Beach
Halls Head Parade, Halls Head
Fees
Early Bird
Race Week
Late Entries
1 November 2014 to 18 January 2015
MSWA Members
$30.00
Non-MSWA Members
$32.00
Monday, 26 January 2015
Registration:
Race Briefing:
Start time:
19 January 2015 to midnight 25 January 2015
MSWA Members
$33.00
Non-MSWA Members
$35.00
7.30 –8.30am
8.30am
9.00am
Major prizes awarded to 1st male and 1st female:
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Overall
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Sub-masters 10-17 (GNOP) *
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18-24 then 5-year age groups (GNOP) *
Race Day, 26 January 2015
MSWA Members
$40.00
Non-MSWA Members
$45.00
* Gaining No Other Prizes
Enter on-line at http://mhmannas.tripod.com , or
www.mswa.asn.au,
This event is part of the HBF Masters Open Water Series for
MSWA members. You must state your HBF Member number to
claim the $5.00 discount on your entry fee.
or download an entry form and post to
Mandurah Masters Swimming Inc
PO Box 1307
Mandurah WA 6210
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Posted entries must be received by the respective closing date.