Your Name (First name, Last name)
Birth Date (DD/MM/YYYY)
Your email address
*Important for communication of changes and updates
How did you
hear about our program?
We have two payment options as follows:
NOTE: The fee does not include Masters Swim Ontario registration required for Masters swim competitions. You can purchase separartely by paying $35 at www.ms.mastersswimmingontario.ca.
Option 1. One-time credit card payment of $235 + HST 13% ($265.55 total) *Includes 3rd party insurance but not MSO registration necessary for competing at swim meets.
— Click Continue below to access PayPal credit card processing
Option 2. Post-dated cheque for $270 (HST incl.) dated Sept. 15 and payable to Anzai! Inc. You must mail to 963 Killeen Avenue, Ottawa ON K2A 2Y1 within 72 hours in order to finalize and secure your registration request. Do not give to the coach on deck. There will be a $20 NSF charge should it be applied. *Includes 3rd party insurance but not MSO registration necessary for competing at swim meets.
— NOTE: For this option, click Continue below and exit PayPal credit card processing.
any conditions that may affect physical exercise:
The purpose of this document is to preclude any claim arising out of my
participation in the activities of swimottawa.com (Anzai! Inc.).
In consideration of the training, coaching and facilities provided to me
by swimottawa.com (Anzai! Inc.):
• I confirm that I am aware that swimming is a sport, which involves
risk, including significant cardiovascular demands.
• I confirm that I am physically fit and able to participate in swimming
at a Masters level and am not aware of nor have I been advised of any physical
limitations to my participation.
• I agree that I will not make any claim for loss, damage, injury
or expense, including any claim based on negligence or breach of contract,
against swimottawa.com (Anzai! Inc.), its members, executive members, volunteers,
trainers, coaches, sponsors, officials or the owners, staff or operators
of any recreational facilities used by swimottawa.com (Anzai! Inc.).
• I agree to indemnify and hold harmless swimottawa.com (Anzai! Inc.)
and those individuals and organizations set out in the preceding paragraph
from any claims for loss, damage, injury or expense associated with my participation
in activities and events sponsored or sanctioned by swimottawa.com (Anzai!
• I agree this document is binding upon me, my personal representatives,
heirs and assigns.
• I understand that there will be no refund, swimmer substitution, or credit arrangements allowances.
I declare I am 18 years of age or older and I have
read and understood the terms of this waiver INCLUDING the no refund, swimmer substitution, or credit arrangements for future sessions.
By clicking 'Continue' you are committing to the Masters drop-in program and the conditions listed above. You will be taken to a secure PayPal link to complete your registration. If you are paying by cheque, click 'Continue' and exit the PayPal screen (send cheque payable to Anzai! Inc. within 24 hours to secure your spot).