Event Overview

/ INDIVIDUAL APPLICATION PROCESS
2016
Event Director: Robert Singer
273 Haviland Road
Queensbury, NY 12804 /
fax: 518-743-9315
www.lakegeorgeswim.com/Marathon

Event Overview

Thank you for your interest in the Lake George Marathon Swim, covering 32 miles between Ticonderoga and the Village of Lake George. The 2016 Marathon Swim is scheduled for September 17, when water temperatures are expected to be 66°F to 70°F, though significantly lower and higher water temperatures have been recorded in mid-September. Swimmers desiring to attempt this swim must be prepared for the challenges of the extreme distance, cold water temperatures, cold weather, turbulent waters, and nighttime swimming, among others.

The Lake George Marathon Swim is also an opportunity for individuals to raise money for a charity of their choice and for charities that support Lake George. Each individual is asked to raise a minimum of $500, to be split evenly between Lake George charities and the individual’s chosen charity. Each individual will determine the beneficiaries of any funds raised in excess of the minimum, and the Swim encourages support for charities supporting Lake George. For more information, please see http://www.lakegeorgeswim.com/marathon/charities.

Swim Support

Each individual swim requires

·  One motorized support boat. This is each swim’s “home base,” which will carry crew, equipment and food, and will provide primary safety support. It is the swimmer’s responsibility to provide a support boat that is rated to carry all required crew and equipment and able to facilitate the swimmer’s removal from the water. We endeavor to secure boats for rent, though the rental costs, which we currently expect to be $400 - $500, will be the swimmer’s responsibility.

·  One boat captain. Each motorized support boat must have a dedicated captain. Providing a captain is primarily the swimmer’s responsibility, though the Swim will also attempt to identify available captains.

·  One official observer. The Swim organizers will provide an official observer for each swim.

·  Crew. Each swimmer must provide at least one crew member or kayaker. While the kayakers are the primary swimmer support, each individual swimmer may provide up to 2 additional crew members, taking into consideration their boat’s capacity and comfort.

·  One kayak with two kayakers. Kayakers will provide primary navigation and nutrition support to the swimmer. Swimmers are encouraged to provide their own kayak and kayakers, and the Lake George Marathon Swim will recruit kayaks and kayakers. If you use a kayak and/or kayakers identified by the Swim, a rental fee may apply and the swimmer may be required to make a donation to the volunteer kayaker’s charity of choice.

·  All participants, crew, kayakers and volunteers are responsible for their own food and water.

/ APPLICATION PROCESS
2016
(continued)

Application Process

You should be aware of the following deadlines, which are further discussed below:

Jan. 15, 2016 Application Form

Jan.-Feb., 2016 Event registration and deposit with a deadline to be provided

June 1, 2016 Completed Medical Form

July 31, 2016 Qualifying Swim Form, and

2016 USMS card (or FINA equivalent or One Event Registration), and

final payment.

Application Form: You are encouraged to submit as soon as possible the basic Application Form containing biographical and contact information for you and your crew, and your open water swimming résumé and 2016 plans. Accepted participants will be conditionally approved until all application materials and final payment have been received by the Swim.

$100 Deposit: Once an application is approved or conditionally approved, we will send a link with a deadline for event registration and payment of the non-refundable deposit. After the deadline provided, we may offer the spot to another swimmer.

Medical Form: As soon as possible, you should schedule an appointment after January 1, 2016 with your physician. You and your physician should only sign the form after the physical exam and any required follow-up are completed. You must also provide the Swim organizers with any updates to your health status up to the commencement of the Swim.

Qualifying Swim Form: If you have completed a Qualifying Swim, please submit this form along with documentation supporting your swim as soon as possible. If you have not completed a Qualifying Swim, provide details of a Qualifying Swim or an Assessment Swim no later than July 31, 2016. We may ask swimmers to provide additional plans to demonstrate specific abilities (e.g., night swimming or swimming in colder water) as part of Qualification.

Final payment: This is the final payment for your registration fees, net of deposits paid.

USMS membership card: All swimmers are required to provide proof of membership with United States Masters Swimming (or a FINA equivalent). Swimmers may submit a 2016 membership card or the USMS One Event Registration Form. Fees for USMS or FINA equivalent memberships are not included in fees for the Lake George Marathon Swim.

/ INDIVIDUAL
APPLICATION
2016
Event Director: Robert Singer
273 Haviland Road
Queensbury, NY 12804 /
fax: 518-743-9315
www.lakegeorgeswim.com/Marathon

Application Instructions

Please be sure your application includes:

q  This signed Application

q  Description of your Charity and Goals: see http://www.lakegeorgeswim.com/marathon/charities

q  Signed Liability Waiver

Biographical Information

Name: / Home phone: / indicate preferred
Address: / Cell phone:
City, State: / Email:
Postal code: / Date of birth:
Country: / Age: / Gender:
T-shirt size: Unisex / or Ladies’ cut / 2016 USMS #:

Emergency Contact

Name: / Relationship:
Home phone: / Email:
Cell phone:

Captain/Crew/Kayakers (attach a copy of this page to provide additional supporting personnel information)

Name: / Home phone: / Indicate
preferred
Address: / Cell phone:
City, State: / Email:
Postal code: / Date of birth:
Country: / Age: / Gender:
T-shirt size: Unisex / or Ladies’ cut / Role:
Name: / Home phone: / indicate preferred
Address: / Cell phone:
City, State: / Email:
Postal code: / Date of birth:
Country: / Age: / Gender:
T-shirt size: Unisex / or Ladies’ cut / Role:
Name: / Home phone: / indicate preferred
Address: / Cell phone:
City, State: / Email:
Postal code: / Date of birth:
Country: / Age: / Gender:
T-shirt size: Unisex / or Ladies’ cut / Role:
/ INDIVIUDAL
APPLICATION
2016
(continued)

Swimming Background

Please list some of your most recent and notable open water events: (attach documentation)

Event / Water temp
Location / Finish time & place
Distance / Winning time
Event / Water temp
Location / Finish time & place
Distance / Winning time
Event / Water temp
Location / Finish time & place
Distance / Winning time
Event / Water temp
Location / Finish time & place
Distance / Winning time

Each swimmer’s background should demonstrate the following:

☐ Long distance/duration ☐ Colder water swimming ☐ Night swimming ☐ Rough water swimming

Highlights of open water swims planned for the current year. These swims should continue to validate the fitness indicated above and should demonstrate a plan to fill any gaps in capabilities.

Swim 1 / Location / Distance
Swim 2 / Location / Distance
Swim 3 / Location / Distance

Fees

Individual swim fee: $400

Deposit: $100 (If your application is accepted or conditionally accepted, we will provide a link to register for the Lake George Marathon Swim and to submit your non-refundable deposit.)

Please remember that each swimmer is responsible for providing for a motorized support boat, kayaks and kayakers. Fees for these items are not included in the Lake George Marathon Swim registration fees. Swimmers are also required to be members of US Masters Swimming (or FINA equivalent) at the time of the Swim.

Charity and Goals

On a separate sheet, please include a description of your personal goals for the Lake George Marathon Swim, the charity you will be supporting and your fundraising goals. We will request periodic updates on your fundraising progress to track the aggregate impact of the fundraising element of the Lake George Marathon Swim.

/ INDIVIUDAL
APPLICATION
2016
(continued)

Participant Declarations

•  I wish to attempt a lengthwise crossing of Lake George.

•  I have read, understand, and agree to abide by the rules and guidelines of the Lake George Marathon Swim, which are available at www.lakegeorgeswim.com/marathon/rules.

•  I certify that I consider I am physically and mentally fit to undertake the Lake George Marathon Swim and have not been otherwise informed by a medical practitioner.

•  I will advise the organizers of any changes in my medical condition that arise before the Marathon Swim.

•  I acknowledge and understand that attempting the Lake George Marathon Swim is an extreme test of my swimming ability, physical conditioning and mental toughness. I am aware of the risks inherent in attempting a marathon swim and the training for such an event, including possible permanent disability or death. I agree to accept and assume all those risks.

• I acknowledge and accept that the provision of certification for a qualifying swim and medical/health condition in no way implies any representation by the Lake George Marathon Swim that the applicant has completed sufficient training or is sufficiently fit or healthy to attempt the Lake George Marathon Swim.

• I am solely responsible for assessing whether I have achieved an appropriate amount and type of training, fitness and health before embarking upon my swim attempt, and I will not make the attempt if for any reason I have failed to achieve this, while still acknowledging that I shall remain solely responsible for all lost fees and expenses.

·  I agree to follow the directions of the Event Director, Safety Monitor, my boat captain, and my escort kayaker. If they declare that the swim is over for me for any reason I will cooperate and leave the water in accordance with their directions.

·  I understand that unpredictable circumstances may result in the cancellation or change in course of the Lake George Marathon Swim before or during the event. Refunds of entry fees may not be refunded. Any refunds will be at the discretion of the Event Director and will depend on the costs and commitments made at the time the event is cancelled.

I hereby waive any and all rights, to the fullest extent permitted by applicable law, to claim for loss or damages against the Lake George Marathon Swim and/or any body affiliated thereto and any of the officials supervising, observing or organizing the event, which arise out of my participation in attempting the Lake George Marathon Swim, or any activities incidental thereto.

Signature

PRINT Full Legal Name:

Signature: Date:

/ LIABILITY
WAIVER
2016

PARTICIPANT WAIVER AND RELEASE OF LIABILITY,

ASSUMPTION OF RISK AND INDEMNITY AGREEMENT

For and in consideration of United States Masters Swimming, Inc. (“USMS”) allowing me, the undersigned, to participate in any USMS sanctioned or approved activity, including swimming camps, clinics, and exhibitions; learn-to-swim programs; swimming tryouts; fitness and training programs (including dryland training); swim practices and workouts (for both pool and open water); pool meets; open water competitions; local, regional, and national competitions and championships (both pool and open water); and related activities (“Event” or “Events”); I, for myself, and on behalf of my spouse, children, heirs and next of kin, and any legal and personal representatives, executors, administrators, successors, and assigns, hereby agree to and make the following contractual representations pursuant to this Waiver and Release of Liability, Assumption of Risk and Indemnity Agreement (the “Agreement”);

1.  I hereby certify and represent that (i) I am in good health and in proper physical condition to participate in the Events; and (ii) I have not been advised of any medical conditions that would impair my ability to safely participate in the Events. I agree that it is my sole responsibility to determine whether I am sufficiently fit and healthy enough to participate in the Events.

2.  I acknowledge the inherent risks associated with the sport of swimming. I understand that my participation involves risks and dangers, which include, without limitation, the potential for serious bodily injury, sickness and disease, permanent disability, paralysis and death (from drowning or other causes); loss of or damage to personal property and equipment; exposure to extreme conditions and circumstances; accidents involving other participants, event staff, volunteers or spectators; contact or collision with natural or manmade objects; dangers arising from adverse weather conditions; imperfect water conditions; water and surface hazards; facility issues; equipment failure; inadequate safety measures; participants of varying skill levels; situations beyond the immediate control of the Event organizers; and other undefined, not readily foreseeable and presently unknown risks and dangers (“Risks”). I understand that these Risks may be caused in whole or in part by my own actions or inactions, the actions or inactions of others participating in the Events, or the negligent acts or omissions of the Released Parties defined below, and I hereby expressly assume all such Risks and responsibility for any damages, liabilities, losses or expenses that I incur as a result of my participation in any Events.

3.  I agree to be familiar with and to abide by the Rules and Regulations established by USMS, including any safety regulations. I accept sole responsibility for my own conduct and actions while participating in the Events.

4.  I hereby Release, Waive and Covenant Not to Sue, and further agree to Indemnify, Defend and Hold Harmless the following parties: USMS, its members, clubs, workout groups, event hosts, employees, and volunteers (including, but not limited to, event directors, coaches, officials, judges, timers, safety marshals, lifeguards, and support boat owners and operators); the USMS Swimming Saves Lives Foundation; USMS Local Masters Swimming Committees (LMSCs); the Event organizers and promoters, sponsors and advertisers; pool facility, lake and property owners or operators hosting the Events; law enforcement agencies and other public entities providing support for the Events; and each of their respective parent, subsidiary and affiliated companies, officers, directors, partners, shareholders, members, agents, employees, and volunteers (individually and collectively, the “Released Parties”), with respect to any liability, claim(s), demand(s), cause(s) of action, damage(s), loss or expense (including court costs and reasonable attorneys’ fees) of any kind or nature (“Liability”) which may arise out of, result from, or relate in any way to my participation in the Events, including claims for Liability caused in whole or in part by the negligent acts or omissions of the Released Parties.