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Open Water Swimming Waiver

Please fill out the following form in order to participate in any of our open water swimming activities.

First name

Last name

Email

Date of Birth

Have you been hospitalized in the last 12 months? *

No

Yes

Are you suffering from any medical conditions, mental health issues, or injury? *

No

Yes

If you answered yes to any question, please elaborate

I declare that the info I’ve provided is accurate & complete

Your Signature

Thanks for submitting!

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