23^nd ANNUAL

INDEPENDENCE DAY

MILE BAY SWIM

FRIDAY, JUNE 26, 2009

6:30 P.M.

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OCCC

Attn: Bay Swim

P.O. Box 973

Ocean City, NJ 08226

RACE APPLICATION

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Waiver and Release

As a participant in the program, I recognize and acknowledge that there are certain risks of physical injury and I agree to assume the full risk of any injuries, damages or loss which I may sustain as a result of participating in any and all activities connected with or associated with such program.

I agree to waive and relinquish all claims I may have as a result of participating in the event against the City of Ocean City and its officers, agents, servants and employees, the Ocean City C-Cerpants, its coaches and Board of Directors.

I do hereby fully release and discharge the City of Ocean City, the Aquatic and Fitness Center and its officers, agents, servants, employees, the Ocean City C-Cerpants, its coaches and Board of Directors from any and all claims from injuries, damage or losses sustained by me arising out of, connected with, or in any way associated with the activities of the event.

I further agree to indemnify and hold harmless and defend the City of Ocean City, the Aquatic & Fitness Center and its officers, agents, servants employees, the Ocean City C-Cerpants, its coaches and Board of Directors from any and all claims from injuries damage or losses sustained by me arising out of, connected with or in anyway associated with the activities of the event

I have read and fully understand the above Event Details, Waiver and Release of all Claims and Permission to Secure Treatment.

Name (Please Print) _____________________________________Date________________________

Signature____________________________________________ (signature of parent if under 18)

Race Information

DATE: Friday, June 26, 2008 TIME: 6:30 P.M. Start

PLACE: Kennedy Park COURSE: Approximately 1 mile in the

bay, beginning and ending

on the beach at Kennedy Park

REGISTRATION: OCCC

ATTN: Bay Swim

P.O. Box 973

Ocean City, NJ 08226

Mail-in registration must be postmarked by June 20, 2008. Checks should be made payable to OCCC. You may register at Kennedy Park from 4:30-6:00 p.m. on race day. Questions, contact Louise Nunan, (609) 398-5068.

ENTRY FEE: $20.00 Pre-registration $25.00 Day of Race

AWARDS: Special trophies for Overall Male and Female first place finishers

Special award for the club with the most participants

1^st, 2^nd and 3^rd in each age group, male and female

10 & under, 11-12, 13-14, 15-16, 17-18, 19-25, 26-30, 31-35, 36-40, 41-45, 46-50, 51-55, 56-60, 61-65, 66 and up

Special Participation Awards for the most Senior and Junior participants who finish the race.

In the event the race is canceled due to weather conditions, no refunds will be given to participants.

Commemorative t-shirts while supplies last

Proceeds benefit the Ocean City C-Cerpants Swim Team.

Timing and Results by L&M Computer Sports. Results www.LMSPORTS.com

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ENTRY FORM (PLEASE PRINT)

NAME____________________________________________________________________

AGE ON DAY OF SWIM____________ SEX-MALE____________FEMALE_______________

ADDRESS_________________________________________________________________

CITY_____________________________________STATE_______ZIP CODE_____________

E-MAIL ADDRESS_____________________________ ______________________________

EMERGENCY CONTACT__________________________PHONE_______________________

FEE ENCLOSED_______________________CLUB AFFILIATION_______________________

NOTE: Waiver on reverse side must be completed