Name *

First Name

Last Name

Phone

(###)

###

####

What event will you be participating in?

Swim

Run

Both swim & run

Do you give Cronulla RSL permission to contact you?

Yes

Waiver *

I agree that I/my child/ward are physically capable to participate in the swim & running events on the 4th May . In the case of an emergency, I authorise Cronulla RSL staff, where it is impracticable to communicate with me, to arrange for me/my child/ward to receive such medical or surgical treatment as may be deemed necessary. I also undertake to pay or reimburse costs which may be incurred for medical attention, ambulance transport and medication while me/my child/ward is participating. I understand that although Cronulla RSL, Cronulla RSL Swimming Club and Rosscos Run Club will attempt to minimise any risk of personal injury within practical boundaries, accidents do happen and all physical activities carry the risk of personal injury. I acknowledge that there is an inherent risk of personal injury in physical activities that will be undertaken and I accept that risk.

I accept