Wlgn Coastal Sea Swim Series - Short Registration

For swimmers who have completed a full registration form already and have swam at least 1 of the Wellington Coastal Swim Series events.

Name *

Name

First Name

Last Name

What part of the coastline are you signing up to swim this weekend

Next of Kin - Name (if details have changed)

Next of Kin - Phone Contact (if details have changed)

Are you able to provide a kayaker?

If you are able to provide a confident kayaker, their safety gear and kayak please indicate below. Anyone who provides a kayaker does not need to pay for 2 swim events in the future. Kayakers will need to be keep an eye on the swimmers around them, rather than any one person. Please provide the Kayaker name & Kayaker Cell Phone Contact.

Terms *

I have read and agreed with the terms of the Personal Waiver in my original registration and am happy with the conditions for all of the swim events. If I do not feel safe I will not get into the water, or if in the water, I will exit as soon as possible.

Payment Options

The $15 entry can be made by internet banking or by cash before the swim.

ACCOUNT NUMBER 02 0828 0088647 000

Inquiries to Jenny - 027 24 23 527