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Thank you for your interest in our Open Water Swim Clinics

Please complete the form below to RSVP to one or both of our upcoming Swim Clinics.
* First Name
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* Last Name
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* Your Email
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* Your Mobile Number
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* Emergency Contact Full Name
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* Emergency Contact Phone Number
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* Dates Available (choose all that apply)

Liability Waiver


I, acknowledge, agree, and represent that I understand and specifically acknowledge the nature and risks inherent in open water swimming including but not limited to serious bodily injury, permanent disability, drowning, paralysis, and death, and agree to accept and assume all of those risks. I further attest and certify that I am physically fit and capable of completing this event.

I hereby grant permission to the Buzzards Bay Coalition’s representatives, to take and use: photographs and/or digital images of me for use in news releases, promotional and/or educational materials. These materials might include printed or electronic publications, websites or other electronic communications. I further agree that my name and identity may be revealed in descriptive text or commentary in connection with the image(s). I authorize the use of these images without compensation to me. All negatives, prints, digital reproductions shall be the property of the Buzzards Bay Coalition.

I hereby release, discharge, and covenant not to sue the Buzzards Bay Coalition, its officers, directors, employees, agents, individuals or institutions associated with this event, from all liability, claims, demands, losses or damages, including but not limited to injuries to my person and/or property, arising from my participation in this event or alleged to be caused in whole or in part by the negligence of the Releasees or others, including negligent rescue operations.

I have read this agreement, fully understand its terms, understand that I have given up substantial rights by signing it and have signed it freely and without any inducement or assurance of any nature and intend it to be a complete and unconditional release of liability to the greatest extent allowed by law and agree that if any portion of this agreement is held to be invalid, the balance, notwithstanding, shall continue in full force and effect.

If you will be under 18 years of age as of the Swim Clinic date, you must submit a signed parental consent prior to event.
* I understand the above liability waiver
* Please write your full name below to confirm.
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* Are you under the age of 18?
By submitting this document, I agree to the Waiver and Release of Liability. If the swimmer is under age 18, a parent/guardian must sign below.
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Submit Application & Waiver

Buzzards Bay Coalition | 114 Front Street | New Bedford, MA 02740 US

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