Pueblo Masters Swim Club

Mission Statement: To promote adult fitness and swimming skills through the support, encouragement, motivation and fun of group swimming.

Member Benefits:

• Share and enjoy your swimming with others.

• Improve your overall fitness.

• Improve your swimming technique.

• Pool time, available with and without coaching.

• Access to swim competitions, such as U.S. Masters, Senior Games, & Age Group.

• Access to open water training for triathlons & open water events.

COMSA Member Benefits:

• A subscription to SWIMMER magazine.

• Member-only access to MyUSMS where you can get workouts, news articles, and other member-only benefits.

• Secondary accident insurance coverage at meets and supervised workouts when all participants are USMS members.

Please visit http://www.jonz.net/PuebloMasters to learn more about our Swim Club. You must also be a member of COMSA (Colorado Masters Swimming Association) if age 18 & older or USA Swimming if under age 18. Visit http://www.comsa.org/index.html or http://www.usaswimming.org for more information.

Pueblo Masters Swim Club Membership Fee = $25.00

Due annually on January 1 with current year COMSA Member Number.

(Please print legibly)

Name ______________________________________ COMSA # _____________________

E-mail address ______________________ @ _________________

Mailing Address ___________________________________________________________

City________________________________________ State_____ Zip_________________

Best contact phone ___________________ Alternate Phone _______________________

Birth date (MM/DD/YYYY) __________________ Sex: M_____ F_____

Mail this application with your check and the signed Waiver and Release from Liability Form to:

Heidi Gard, 552 E. Earl Dr., Pueblo West, CO 81007

Pueblo Masters Swim Club is affiliated with COMSA. COMSA the Local Masters Swimming Committee (LMSC) is charged with regulating all masters swimming activities in the states of Colorado and Wyoming. United States Masters Swimming (USMS) is a national organization that provides organized swim practices, competitions, and clinics for adults 18 and over. USMS is open to all swimmers (fitness, triathlete, competitive and non-competitive) who want to improve their fitness and swimming technique.

Waiver and Release from Liability

PLEASE READ CAREFULLY BEFORE SIGNING.

THIS IS A RELEASE OF LIABILITY AND WAIVER OF CERTAIN LEGAL RIGHTS.

In consideration for my being permitted to swim with the Pueblo Masters Swim Club, I agree to the following waiver and release:

I, the undersigned participant, intending to be legally bound, acknowledge that swimming and volunteering to work in club activities have inherent risks, hazards and dangers. I hereby certify that I am physically fit and have not been otherwise informed by a physician. I will not participate in Pueblo Masters activities unless I am medically able and properly trained. I agree to abide by any decision of supervisory personnel on deck or in the pool relative to my ability to participate safely. I acknowledge that I am aware of all the risks inherent in Masters Swimming (training and competition), including, but not limited to, drowning, falls, contact with other participants, the effects of weather, the conditions of the pool and facilities, and I hereby assume and accept any and all risks of injury, paralysis or death. As a condition of my participation in the Masters Swimming program or any activities incident thereto, I hereby waive any and all rights to claims for loss or damages, including all claims for loss or damages caused by the negligence, active or passive, of the following: Pueblo Masters Swim Club, United States Masters Swimming, Inc., local Masters swimming personnel, Pueblo City Schools, Pueblo School District No. 70, Colorado State University-Pueblo, and the City of Pueblo, their directors, officers, agents, employees, and volunteers. In addition, I agree to abide by and be governed by the rules of USMS.

I, for myself, my heirs, successors, executors and subrogees, hereby knowingly and intentionally waive and release, indemnify and hold harmless parties named above from and against any and all claims, actions, causes of action, liabilities, suits, expenses (including reasonable attorneys' fees) and negligence of any kind or nature, whether foreseen or unforeseen, arising directly or indirectly out of any damage, loss, injury, paralysis, or death to me or my property as a result of my use of their pool and facilities, whether such damage, loss, injury, paralysis, or death results from negligence of said parties or from some other cause.

This release is intended to be a comprehensive release of liability but is not intended to assert defenses which are prohibited by law.

I HAVE CAREFULLY READ, CLEARLY UNDERSTAND AND VOLUNTARILY SIGN THIS USE, WAIVER AND RELEASE AGREEMENT

Name (print) _____________________________________________________________

Address (Street, City, State, Zip Code) ________________________________________

_______________________________________________________________________

Signature _____________________________________________ Date _____________

Parent or Guardian if under age 18:

Signature _____________________________________________ Date _____________