Risk Acceptance Form (Unsupervised Open-Water Swimming Gatineau River)

1. Activité Description

I acknowledge that I am voluntarily participating, or that my child under the age of 16 is voluntarily participating, in an open water swimming activity within an unsupervised and marked swimming corridor approximately 125 metres in length, established by the Municipality of Chelsea on the Gatineau River.

2. Participant Information

Who is this risk acceptance being completed for?•

For me

For my child under the age of 16

For Both

Information of the Applicant

Child Information

Child First Name•

Child Last Name•

Parent or Guardian Information

Child Information

Child First Name•

Child Last Name•

Information of the Adult Participant and Parent or Guardian

First Name•

Last Name•

Telephone

Email•

3. Risk Acknowledgment and Acceptance

I understand that open water swimming takes place in a natural, undeveloped, and unsupervised environment, and that the activity involves inherent risks, including, but not limited to:

Drowning;
Variations in current or water depth;
Cold water and the risk of hypothermia;
Injuries caused by natural obstacles (rocks, branches, debris);
The presence of fish, insects, algae, or other living organisms in the aquatic environment;
Fatigue, cramps, or physical discomfort;
Variable water quality;
Changing weather conditions;
The possible presence of boats or other river users;
Risks related to the relative distance from emergency services.

I confirm that I am in good physical condition to participate in this activity and possess adequate swimming skills for open water swimming, and/or that my child under the age of 16 is in good physical condition and has the necessary abilities for open water swimming.

•

4. Prohibited Activities Within the Swimming Corridor

Diving;
Recreational bathing, floating, and lounging;
Navigation by motorized and non-motorized watercraft;
Fishing.

I confirm that I have read and understand the prohibited activities within the swimming corridor.

•

5. Compliance with Safety Instruction

Respecting the swimming corridor opening hours (7:00 a.m. to 2 hours before sunset);
Remaining within the swimming corridor marked by buoys;
Swimming in the direction indicated on the signage;
If I am signing this form on behalf of my child under the age of 16, ensuring that the child is accompanied by an adult while participating in the activity;
Checking weather forecasts before swimming; access to the swimming corridor is prohibited in the event of a thunderstorm;
Using mandatory equipment (safety buoy, brightly coloured swim cap, whistle, wetsuit if the water temperature is between 16 and 18 degrees Celsius);
Not swimming if the water temperature is below 16 degrees Celsius;
Stopping the activity in case of fatigue, discomfort, or any perceived dangerous conditions;
Stopping the activity in the event of lightning, thunder, or strong winds;
Not participating under the influence of drugs or alcohol;
It is strongly recommended to be able to swim a minimum distance of 125 metres without touching the bottom to use the swimming corridor;
It is strongly recommended to be accompanied while participating in the activity;
Reporting the presence of any obstacles to the Municipality of Chelsea by submitting a report on Pivot.

I agree, for myself and/or for the child under my responsibility, to comply with all established safety rules and instructions listed above.

•

6. Release of liability

By signing this form, I acknowledge that I understand the risks associated with open water swimming and agree to participate voluntarily, for myself and/or for the child under the age of 16 under my responsibility. I understand that I am responsible for my own safety or that of the child, and for stopping the activity if conditions become dangerous.

I hereby release and hold harmless the Municipality, its employees, volunteers, and partners from any and all liability for any injury, loss, or damage that may occur during my participation or that of the child under my responsibility in this activity, except in cases of gross negligence or intentional misconduct in accordance with applicable laws.

I acknowledge the risks associated with this activity and confirm that I participate voluntarily, assuming full responsibility for my safety and/or that of the child under my care, and I release the Municipality and its representatives from liability as outlined above.

•

7. Collection and Use of Personal Information

By signing this form, I consent to my personal information, as well as that of the child under the age of 16 under my responsibility, where applicable, being used by the Municipality of Chelsea and its employees or volunteers for the administration of the open water swimming activity. This information will be retained in accordance with the Municipality’s records retention schedule. (Mandatory)

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I agree to receive a short email survey at the end of the season to help improve the open water swimming corridor project. (Optional)

8. Confirmation and Signature

I confirm that I have read and understood this form and accept the risks associated with this activity.

•

Participant Name•

Parent or Gardian Name•

Participant and Parent or Gardian Name•

Signature •

Date

Risk Acceptance Form (Unsupervised Open-Water Swimming - Gatineau River)

This form uses the reCAPTCHA functionality to submit your request.

1. Activité Description

2. Participant Information

Information of the Applicant

Child Information

Parent or Guardian Information

Child Information

Information of the Adult Participant and Parent or Guardian

3. Risk Acknowledgment and Acceptance

4. Prohibited Activities Within the Swimming Corridor

5. Compliance with Safety Instruction

6. Release of liability

7. Collection and Use of Personal Information

8. Confirmation and Signature

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Risk Acceptance Form (Unsupervised Open-Water Swimming - Gatineau River)

This form uses the reCAPTCHA functionality to submit your request.

1. Activité Description

2. Participant Information

Information of the Applicant

Child Information

Parent or Guardian Information

Child Information

Information of the Adult Participant and Parent or Guardian

3. Risk Acknowledgment and Acceptance

4. Prohibited Activities Within the Swimming Corridor

5. Compliance with Safety Instruction

6. Release of liability

7. Collection and Use of Personal Information

8. Confirmation and Signature