97ú Snámh na Life, Baile Ãtha Cliath - cloudfront.net
97ú Snámh na Life, Baile Átha Cliath 97th Dublin City Liffey Swim Leinster Open Sea Saturday 6th August 2016 Visitors’ Race – Overseas Entry Form
SwimTrek Participants This completed form must be completed and emailed immediately on making your booking so that your suitability to take part in the event can be assessed. Forms must be emailed within 48hours of your booking. 1. 2. 3. 4.
Read the race information and declarations Print and complete page 4 and 5 Photograph or scan your completed page 4 and 5 Attach your form to an email and send it to [email protected]
SwimTrek will contact you within 12 days to confirm your entry to Liffey Swim Race. You should wait to hear your application has been accepted by the Liffey Swim organisers before you book your travel to Dublin. If you have any queries about your suitability to take part please contact SwimTrek before making your booking. A one-day Swim Ireland licence is included in your SwimTrek package. Please leave the Club and Overseas Governing Body Number Registration Number empty if you are not a member of a swimming club. If you are a member of swimming club in your home country which is affiliated to FINA, please complete your details on the form.
Dublin City Liffey Swim Visitors’ Race – Overseas This entry form is for SwimTrek participants who live outside of Ireland and would like to swim in the 97th Dublin City Liffey Swim in the Visitors’ Race. The form must be attached to your SwimTrek online profile (travel details section). The Dublin City Liffey Swim is approximately 2,200 metres. The water temperature can vary from 9 degrees to 15 degrees Celsius. Swimmers in the Visitors’ race must be eighteen years of age on the 1 September 2016. Selection of Entries Leinster Open Sea will review the information you supply in this form before offering you a place in the 97th Dublin City Liffey swim. Leinster Open sea will allocate places to overseas swimmers based on our assessment of their ability to complete the 97th Dublin City Liffey Swim. Places are limited. Acceptance of this form or entry fee does not guarantee entry.
i
97ú Snámh na Life, Baile Átha Cliath 97th Dublin City Liffey Swim Leinster Open Sea Saturday 6th August 2016 Visitors’ Race – Overseas Entry Form Start time, Cancellation and Postponement Start times for the men’s and women’s races will be announced at the SwimTrek welcome meeting on Friday August 5th 2016. Leinster Open Sea reserve the right to: cancel the Dublin City Liffey Swim if conditions are unsafe; change the start time of the races to accommodate requests from the Port Authorities; change the start time of the races to accommodate conditions in the river; or refuse admission to the Dublin City Liffey Swim. Leinster Open Sea will not refund entry fees in the event that the Dublin City Liffey Swim is cancelled, postponed, start time changed or if a swimmer is asked to retire or refused admission to the race. Wetsuits Wetsuits are not allowed in the Dublin City Liffey Swim Disqualification from 97th Dublin City Liffey Swim Leinster Open Sea will disqualify swimmers who: leave the course or the finish area without ensuring their name is marked off the list of swimmers; do not obey instructions given by race officials or rescue crews; commence swimming before their given start time per the published handicap and called out by the race starter; fail to follow the course or fail to go around designated marker buoys; and or win places or prizes but do not turn up on time for the presentations attended by sponsors and VIPs. The above list is not exhaustive. Environmental Health Guidelines for Liffey Swim The River Liffey is an urban watercourse, which may suffer from occasional un-intended pollution. You may be at risk of contracting infections and diseases including the following Leptospirosis (Weil’s disease), E coli infections, Cryptospiridiosis and Hepatitis. (The list is not exhaustive.)
Before entering the water, cover all cuts and abrasions with a waterproof dressing. Ensure that all earplugs, swim goggles and nose plugs are in place before you enter the water. Shower thoroughly and immediately after the swim. If you get a flu-like illness within a three week period after the swim, contact your doctor immediately and tell his that you were swimming in the River Liffey where there is a risk of Leptospirosis.
If you suffer from a medical condition or are recovering from illness you should consult with your doctor before entering the 97th Dublin City Liffey Swim or competing in open water swimming.
ii
97ú Snámh na Life, Baile Átha Cliath 97th Dublin City Liffey Swim Leinster Open Sea Saturday 6th August 2016 Visitors’ Race – Overseas Entry Form Declarations I confirm that I am: in good health and have no physical condition, disease or injury which will impair me from swimming in the 97th Dublin City Liffey Swim and completing the race course (2,200 metres to be confirmed); acclimatised to swimming in open water / open sea without a wetsuit in temperatures from 9 to 15 Celsius; bound by the Swim Ireland Rule Book, Code of Conduct, Complaints and Disciplinary procedures; and bound by the rules of Leinster Open Sea as published on www.leinsteropensea.ie. I confirm that I will: comply with all instructions given to me by race officials and rescue crews; retire from the race if requested to do so by race officials or rescue crews; leave the water and retire if I exceed the cut off time (1 hour (to be confirmed)); ensure that my name is crossed of the list of swimmers by a race official on completion of the course; wear the numbered swim cap provided and refrain from wearing or displaying any branded material from previous Dublin City Liffey Swims; ensure that my clothes and belonging are stored in a bag with my name, club and phone number clearly labelled on the bag; and not litter or leave rubbish at the Dublin City Liffey Swim. If race officials or rescue crews consider that I am suffering from fatigue, hypothermia or disorientation or consider that I am in difficulty or danger, I authorise race officials and rescue crews to remove me from the water and bring me to a place of safety where I may obtain medical assistance. I authorise Leinster Open Sea to use my photograph or digital image for publicity and media purposes. I confirm that if I win a place or a prize that I will be available and on time for the presentation attended by sponsors and VIPs. I agree that if I do not turn up on time for the presentation that I will forfeit my prize. All Swimmers in the 97th Dublin City Liffey Swim and the Leinster Open Sea Races swim at their own risk. I am aware of the risks of open water swimming and like all sports it carries the risk of injury, paralysis or death. I am entering the 97th Dublin City Liffey Swim of my own free will. I hereby agree to keep Leinster Open Sea, rescue crews, Swim Ireland, Dublin City Council and all other sponsors free from any legal claim however caused by my participation in the 97th Dublin City Liffey Swim or by my participation in any of the other Leinster Open Sea Races.
iii
97ú Snámh na Life, Baile Átha Cliath 97th Dublin City Liffey Swim Leinster Open Sea Saturday 6th August 2016 Visitors’ Race – Overseas Entry Form I agree to the rules and conditions of Leinster Open Sea as published on the Leinster Open Sea Website www.leinsteropensea.ie and the entry conditions for the 96th Dublin City Liffey Swim. Signature and Date
Name Address
Email Club Overseas Governing Body Number Registration Number
Mobile Number
Date of Birth
Nationality
Name of next of kin Email Address of next of kin Phone Number Next of Kin
Please outline how you heard about the Dublin City Liffey Swim ?
iv
Sex (M/F)
97ú Snámh na Life, Baile Átha Cliath 97th Dublin City Liffey Swim Leinster Open Sea Saturday 6th August 2016 Visitors’ Race – Overseas Entry Form Please give the name and address of your swimming club? Leave this part empty if you do not have a club.
Please outline your open water swimming experience including swimming in water from 9 to 15 Celsius?
Please outline your normal weekly swimming training?
Please disclose any medical condition, which you may suffer from?
Please list Open Water Races or Swims you have participated in since 1 June 2014 (Non wetsuit)? Race or Date Location Distance Your Time Water Swim (Kilometre) Temperature
Handicapped Race Leinster Open Sea run the Leinster Open Sea Races including the Dublin City Liffey Swim under a handicap system so as to give each swimmer an opportunity of wining in their respective competition. In order to help the Handicapper to assess you, we ask that you give the handicapper an honest and fair assessment of your times for some or all of the following 100 Metres 200 Metres
400 Metres
1,000 Metres
v
SwimTrek Participants This completed form must be completed and emailed immediately on making your booking so that your suitability to take part in the event can be assessed. Forms must be emailed within 48hours of your booking. 1. 2. 3. 4.
Read the race information and declarations Print and complete page 4 and 5 Photograph or scan your completed page 4 and 5 Attach your form to an email and send it to [email protected]
SwimTrek will contact you within 12 days to confirm your entry to Liffey Swim Race. You should wait to hear your application has been accepted by the Liffey Swim organisers before you book your travel to Dublin. If you have any queries about your suitability to take part please contact SwimTrek before making your booking. A one-day Swim Ireland licence is included in your SwimTrek package. Please leave the Club and Overseas Governing Body Number Registration Number empty if you are not a member of a swimming club. If you are a member of swimming club in your home country which is affiliated to FINA, please complete your details on the form.
Dublin City Liffey Swim Visitors’ Race – Overseas This entry form is for SwimTrek participants who live outside of Ireland and would like to swim in the 97th Dublin City Liffey Swim in the Visitors’ Race. The form must be attached to your SwimTrek online profile (travel details section). The Dublin City Liffey Swim is approximately 2,200 metres. The water temperature can vary from 9 degrees to 15 degrees Celsius. Swimmers in the Visitors’ race must be eighteen years of age on the 1 September 2016. Selection of Entries Leinster Open Sea will review the information you supply in this form before offering you a place in the 97th Dublin City Liffey swim. Leinster Open sea will allocate places to overseas swimmers based on our assessment of their ability to complete the 97th Dublin City Liffey Swim. Places are limited. Acceptance of this form or entry fee does not guarantee entry.
i
97ú Snámh na Life, Baile Átha Cliath 97th Dublin City Liffey Swim Leinster Open Sea Saturday 6th August 2016 Visitors’ Race – Overseas Entry Form Start time, Cancellation and Postponement Start times for the men’s and women’s races will be announced at the SwimTrek welcome meeting on Friday August 5th 2016. Leinster Open Sea reserve the right to: cancel the Dublin City Liffey Swim if conditions are unsafe; change the start time of the races to accommodate requests from the Port Authorities; change the start time of the races to accommodate conditions in the river; or refuse admission to the Dublin City Liffey Swim. Leinster Open Sea will not refund entry fees in the event that the Dublin City Liffey Swim is cancelled, postponed, start time changed or if a swimmer is asked to retire or refused admission to the race. Wetsuits Wetsuits are not allowed in the Dublin City Liffey Swim Disqualification from 97th Dublin City Liffey Swim Leinster Open Sea will disqualify swimmers who: leave the course or the finish area without ensuring their name is marked off the list of swimmers; do not obey instructions given by race officials or rescue crews; commence swimming before their given start time per the published handicap and called out by the race starter; fail to follow the course or fail to go around designated marker buoys; and or win places or prizes but do not turn up on time for the presentations attended by sponsors and VIPs. The above list is not exhaustive. Environmental Health Guidelines for Liffey Swim The River Liffey is an urban watercourse, which may suffer from occasional un-intended pollution. You may be at risk of contracting infections and diseases including the following Leptospirosis (Weil’s disease), E coli infections, Cryptospiridiosis and Hepatitis. (The list is not exhaustive.)
Before entering the water, cover all cuts and abrasions with a waterproof dressing. Ensure that all earplugs, swim goggles and nose plugs are in place before you enter the water. Shower thoroughly and immediately after the swim. If you get a flu-like illness within a three week period after the swim, contact your doctor immediately and tell his that you were swimming in the River Liffey where there is a risk of Leptospirosis.
If you suffer from a medical condition or are recovering from illness you should consult with your doctor before entering the 97th Dublin City Liffey Swim or competing in open water swimming.
ii
97ú Snámh na Life, Baile Átha Cliath 97th Dublin City Liffey Swim Leinster Open Sea Saturday 6th August 2016 Visitors’ Race – Overseas Entry Form Declarations I confirm that I am: in good health and have no physical condition, disease or injury which will impair me from swimming in the 97th Dublin City Liffey Swim and completing the race course (2,200 metres to be confirmed); acclimatised to swimming in open water / open sea without a wetsuit in temperatures from 9 to 15 Celsius; bound by the Swim Ireland Rule Book, Code of Conduct, Complaints and Disciplinary procedures; and bound by the rules of Leinster Open Sea as published on www.leinsteropensea.ie. I confirm that I will: comply with all instructions given to me by race officials and rescue crews; retire from the race if requested to do so by race officials or rescue crews; leave the water and retire if I exceed the cut off time (1 hour (to be confirmed)); ensure that my name is crossed of the list of swimmers by a race official on completion of the course; wear the numbered swim cap provided and refrain from wearing or displaying any branded material from previous Dublin City Liffey Swims; ensure that my clothes and belonging are stored in a bag with my name, club and phone number clearly labelled on the bag; and not litter or leave rubbish at the Dublin City Liffey Swim. If race officials or rescue crews consider that I am suffering from fatigue, hypothermia or disorientation or consider that I am in difficulty or danger, I authorise race officials and rescue crews to remove me from the water and bring me to a place of safety where I may obtain medical assistance. I authorise Leinster Open Sea to use my photograph or digital image for publicity and media purposes. I confirm that if I win a place or a prize that I will be available and on time for the presentation attended by sponsors and VIPs. I agree that if I do not turn up on time for the presentation that I will forfeit my prize. All Swimmers in the 97th Dublin City Liffey Swim and the Leinster Open Sea Races swim at their own risk. I am aware of the risks of open water swimming and like all sports it carries the risk of injury, paralysis or death. I am entering the 97th Dublin City Liffey Swim of my own free will. I hereby agree to keep Leinster Open Sea, rescue crews, Swim Ireland, Dublin City Council and all other sponsors free from any legal claim however caused by my participation in the 97th Dublin City Liffey Swim or by my participation in any of the other Leinster Open Sea Races.
iii
97ú Snámh na Life, Baile Átha Cliath 97th Dublin City Liffey Swim Leinster Open Sea Saturday 6th August 2016 Visitors’ Race – Overseas Entry Form I agree to the rules and conditions of Leinster Open Sea as published on the Leinster Open Sea Website www.leinsteropensea.ie and the entry conditions for the 96th Dublin City Liffey Swim. Signature and Date
Name Address
Email Club Overseas Governing Body Number Registration Number
Mobile Number
Date of Birth
Nationality
Name of next of kin Email Address of next of kin Phone Number Next of Kin
Please outline how you heard about the Dublin City Liffey Swim ?
iv
Sex (M/F)
97ú Snámh na Life, Baile Átha Cliath 97th Dublin City Liffey Swim Leinster Open Sea Saturday 6th August 2016 Visitors’ Race – Overseas Entry Form Please give the name and address of your swimming club? Leave this part empty if you do not have a club.
Please outline your open water swimming experience including swimming in water from 9 to 15 Celsius?
Please outline your normal weekly swimming training?
Please disclose any medical condition, which you may suffer from?
Please list Open Water Races or Swims you have participated in since 1 June 2014 (Non wetsuit)? Race or Date Location Distance Your Time Water Swim (Kilometre) Temperature
Handicapped Race Leinster Open Sea run the Leinster Open Sea Races including the Dublin City Liffey Swim under a handicap system so as to give each swimmer an opportunity of wining in their respective competition. In order to help the Handicapper to assess you, we ask that you give the handicapper an honest and fair assessment of your times for some or all of the following 100 Metres 200 Metres
400 Metres
1,000 Metres
v
