21st Annual LCKC Polar Bear Plunge
 
2014 Polar Bear Plunge

Event Registration

Jump in Lanier to kick off your year!
 

Lanier Canoe and Kayak Club

Lake Lanier Olympic Venue
3105 Clarks Bridge Rd
Gainesville, GA 30506
770-287-7888

Event Date: January 1, 2019

Check-In and On-site Registration opens at 10:45 AM. Please arrive before 11:30 AM. Jumping starts at noon.

Event will take place behind the boat house at Lake Lanier Olympic Park.

Registration includes a hot bowl of chili, desserts and warm drinks to warm back up after the jump. All pre-registered participants will receive an event t-shirt in their size. If supplies run out at the event additional t-shirts will be ordered and delivered to participants that may not have receievd one.

Registration Type *
LCKC is a non-profit 501(c)3 organization and we depend on your donations, which are tax deductible, to continue providing exciting recreational and competitive programs for youth and adults. Please consider entering an additional donation below to help continue this Olympic Legacy program.

Individual/First Jumper Information
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Did an LCKC athlete refer/convince you to take the plunge? If so, enter their name below to help them earn fundraising credit toward their training. 
* RELEASE AND WAIVER OF LIABILITY, ASSUMPTION OF RISH AND IMDEMNITY In consideration of being permitted to participate in any way in the Lanier Canoe and Kayak Club Polar Bear Swim I, for myself, my personal representatives, assigns, heirs and next of kin: 1. Acknowledge, agree and represent that I understand the nature of this event and that I am qualified, in good health, and in proper physical condition to participate in such activity. I further acknowledge that the activity will be conducted in winter conditions on and in Lake Lanier, Gainesville, GA. I further agree and warrant that if at any time I believe conditions to be unsafe, I will immediately discontinue further participation in the activity. 2. Hereby release, discharge, and covenant not to sue the club, USACK, their respective administrators, directors, agents, officers, members, volunteers, and employees, other participants, any sponsors, advertisers, and, if applicable, owners and lessors, of premises on which the activity takes place, (Each considered one of the “Releasees” herein) from all liability, claims, demands, losses, or damages on my account caused or alleged to be caused in whole or in part by the negligence of the “releasees” or otherwise, including negligent rescue operations; and I further agree that if, despite this release and waiver of liability, assumption of risk, and indemnity agreement I, or anyone on my behalf, makes a claim against any of the releasees, I will indemnify, save, and hold harmless each of the releasees from any litigation expenses, attorney fees, loss, liability, damage, or cost which any may incur as the result of such claim.

Consent for Release of Information

We respect and protect the privacy of our Registrants. Personal information is used only for canoe/kayak purposes. The following are examples where information or photos may be used:

• The use of an athlete’s name and/or photo in LCKC newsletters, on our website, bulletin boards and local newspapers.

• The taking of individual or team photo.

• The use of an athlete’s name and/or photo in regatta programs, etc.

• The circulation of information promoting canoe/kayak information and opportunities.

I hereby give consent for the Lanier Canoe Kayak Club to use information and/or photos for the purposes specified above.

Second Jumper Information

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Register another family member? *
* RELEASE AND WAIVER OF LIABILITY, ASSUMPTION OF RISH AND IMDEMNITY In consideration of being permitted to participate in any way in the Lanier Canoe and Kayak Club Polar Bear Swim I, for myself, my personal representatives, assigns, heirs and next of kin: 1. Acknowledge, agree and represent that I understand the nature of this event and that I am qualified, in good health, and in proper physical condition to participate in such activity. I further acknowledge that the activity will be conducted in winter conditions on and in Lake Lanier, Gainesville, GA. I further agree and warrant that if at any time I believe conditions to be unsafe, I will immediately discontinue further participation in the activity. 2. Hereby release, discharge, and covenant not to sue the club, USACK, their respective administrators, directors, agents, officers, members, volunteers, and employees, other participants, any sponsors, advertisers, and, if applicable, owners and lessors, of premises on which the activity takes place, (Each considered one of the “Releasees” herein) from all liability, claims, demands, losses, or damages on my account caused or alleged to be caused in whole or in part by the negligence of the “releasees” or otherwise, including negligent rescue operations; and I further agree that if, despite this release and waiver of liability, assumption of risk, and indemnity agreement I, or anyone on my behalf, makes a claim against any of the releasees, I will indemnify, save, and hold harmless each of the releasees from any litigation expenses, attorney fees, loss, liability, damage, or cost which any may incur as the result of such claim.

Consent for Release of Information

We respect and protect the privacy of our Registrants. Personal information is used only for canoe/kayak purposes. The following are examples where information or photos may be used:

• The use of an athlete’s name and/or photo in LCKC newsletters, on our website, bulletin boards and local newspapers.

• The taking of individual or team photo.

• The use of an athlete’s name and/or photo in regatta programs, etc.

• The circulation of information promoting canoe/kayak information and opportunities.

I hereby give consent for the Lanier Canoe Kayak Club to use information and/or photos for the purposes specified above.

Third Jumper Information

calendar
Register another family member? *
* RELEASE AND WAIVER OF LIABILITY, ASSUMPTION OF RISH AND IMDEMNITY In consideration of being permitted to participate in any way in the Lanier Canoe and Kayak Club Polar Bear Swim I, for myself, my personal representatives, assigns, heirs and next of kin: 1. Acknowledge, agree and represent that I understand the nature of this event and that I am qualified, in good health, and in proper physical condition to participate in such activity. I further acknowledge that the activity will be conducted in winter conditions on and in Lake Lanier, Gainesville, GA. I further agree and warrant that if at any time I believe conditions to be unsafe, I will immediately discontinue further participation in the activity. 2. Hereby release, discharge, and covenant not to sue the club, USACK, their respective administrators, directors, agents, officers, members, volunteers, and employees, other participants, any sponsors, advertisers, and, if applicable, owners and lessors, of premises on which the activity takes place, (Each considered one of the “Releasees” herein) from all liability, claims, demands, losses, or damages on my account caused or alleged to be caused in whole or in part by the negligence of the “releasees” or otherwise, including negligent rescue operations; and I further agree that if, despite this release and waiver of liability, assumption of risk, and indemnity agreement I, or anyone on my behalf, makes a claim against any of the releasees, I will indemnify, save, and hold harmless each of the releasees from any litigation expenses, attorney fees, loss, liability, damage, or cost which any may incur as the result of such claim.

Consent for Release of Information

We respect and protect the privacy of our Registrants. Personal information is used only for canoe/kayak purposes. The following are examples where information or photos may be used:

• The use of an athlete’s name and/or photo in LCKC newsletters, on our website, bulletin boards and local newspapers.

• The taking of individual or team photo.

• The use of an athlete’s name and/or photo in regatta programs, etc.

• The circulation of information promoting canoe/kayak information and opportunities.

I hereby give consent for the Lanier Canoe Kayak Club to use information and/or photos for the purposes specified above.

Last Jumper Information

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* RELEASE AND WAIVER OF LIABILITY, ASSUMPTION OF RISH AND IMDEMNITY In consideration of being permitted to participate in any way in the Lanier Canoe and Kayak Club Polar Bear Swim I, for myself, my personal representatives, assigns, heirs and next of kin: 1. Acknowledge, agree and represent that I understand the nature of this event and that I am qualified, in good health, and in proper physical condition to participate in such activity. I further acknowledge that the activity will be conducted in winter conditions on and in Lake Lanier, Gainesville, GA. I further agree and warrant that if at any time I believe conditions to be unsafe, I will immediately discontinue further participation in the activity. 2. Hereby release, discharge, and covenant not to sue the club, USACK, their respective administrators, directors, agents, officers, members, volunteers, and employees, other participants, any sponsors, advertisers, and, if applicable, owners and lessors, of premises on which the activity takes place, (Each considered one of the “Releasees” herein) from all liability, claims, demands, losses, or damages on my account caused or alleged to be caused in whole or in part by the negligence of the “releasees” or otherwise, including negligent rescue operations; and I further agree that if, despite this release and waiver of liability, assumption of risk, and indemnity agreement I, or anyone on my behalf, makes a claim against any of the releasees, I will indemnify, save, and hold harmless each of the releasees from any litigation expenses, attorney fees, loss, liability, damage, or cost which any may incur as the result of such claim.

Consent for Release of Information

We respect and protect the privacy of our Registrants. Personal information is used only for canoe/kayak purposes. The following are examples where information or photos may be used:

• The use of an athlete’s name and/or photo in LCKC newsletters, on our website, bulletin boards and local newspapers.

• The taking of individual or team photo.

• The use of an athlete’s name and/or photo in regatta programs, etc.

• The circulation of information promoting canoe/kayak information and opportunities.

I hereby give consent for the Lanier Canoe Kayak Club to use information and/or photos for the purposes specified above.