This form is to be used by customers who wish to register via check. To join one of our trips, please fill out this form, then send the required deposit (see the pricing section of your Trip for deposit information) to SwimVacation, PO Box 40, Bath, ME 04530. * Required Your Name * Your Email * Participant Name(s) * List all participants, including swimmers and non-swimmers Birth Date(s) and Age(s) * List all participants, including swimmers and non-swimmers Participant Mailing Address(es) * Cell Phone Number * Email Address * List more than one if you wish. Emergency Contact Information * Please list name and phone number Medical Information * Please list any pre-existing medical conditions, including allergies Special Dietary Needs * Vegetarian, Lactose intolerance, Diabetic, etc. What trip are you registering for? * British Virgin IslandsHawaiiTurkish Coast Please list trip dates you wish to attend * Please list swimming experience level for all participants * eg; strong open water swimmer or beginner triathlete, etc. Provide time for a 1 mile swim if you have one. Goals and Expectations * Please check all the items you are interested in A relaxing vacationSwimming in a beautiful settingSwimming fasterStroke/technique improvementOther: How did you hear about SwimVacation? * USMS Magazine AdOther print advertisementGoogle or other internet searchFriendEmailOther: Acknowledgement * I have read and agree to the following Waiver: Indemnification -I do hereby release SwimVacation and all persons or entities associated with this trip, including owners, guides, lifeguards, and hired captain and crew of all liability related to injuries or accidents which may occur as a result of participation in SwimVacation. I hereby agree to comply with all the rules and instructions provided by SwimVacation staff. I hereby represent that I am physically capable of participating in SwimVacation, and that I will conduct myself in a safe and prudent manner while participating in the trip. I hereby acknowledge that there are always certain risks associated with any physical activity. I understand the risks and declare myself to be physically sound and capable to participate in SwimVacation. I hereby consent to receive medical treatment which may be deemed advisable in the event of injury, accident or illness during SwimVacation. No warranty as to the quality of medical care is be made. I hereby acknowledge that I have sole responsibility for my personal possessions and athletic equipment during SwimVacation. I hereby absolve and hold harmless all and any parties or entities associated with SwimVacation from any damage I may sustain because of any breach of these representations.I have read and agree to the following Terms and Conditions: Cancellation Policy - Should you decide to cancel your vacation, the following charges will apply: Cancellations 8 or more weeks prior to start date: retention of deposit; between 8 and 4 weeks: retention of 70% of total fees; less than 4 weeks: retention of 100% of total fees. Cancellation by Operator -All trips have a minimum number of 6 guests to run. SwimVacation reserves the right to cancel departures in cases where fewer than 6 guests have registered 12 weeks prior to the trip, or in cases of force majeure or the failure of third parties, including chartered vessels or leased properties, to honor their reservations. In all of these cases all payments received to date by SwimVacation will be refunded. SwimVacation is not responsible for expenses that are incurred in preparation for any cancelled trips, including third party online booking fees, airline tickets, or for costs that are incurred due to airline delays, flight cancellation, or illness. Insurance - All SwimVacation customers must be self insured for medical and repatriation costs, and for all activities you will pursue on your vacation. Health Requirements - All SwimVacation customers must be in good physical health to safely enjoy all the activities we offer. Signature(s) on the reservation form certify that the participants do not have any physical problems that would put themselves, other participants, SwimVacation employees, or yacht crews at risk. Swimming Ability - All swimming participants must be capable of maintaining a steady pace for at least 2 miles, and must be familiar with the occasional rigors of open water swimming. Our typical customer swims at least twice a week and has a good level of fitness. Passport - A valid passport with an expiration date not less than 6 months after your return is required for all trips to the British Virgin Islands. It is the responsibility of the participants to obtain or renew their passports. Traveling to the starting point - It is the responsibility of the participants to arrive at the correct location at the scheduled time of trip departure.