2025 EPBC POLAR ICE PLUNGE

Wednesday, January 1, 2025 at East Peoria Boat Club in East Peoria, IL

What category would you like to sign up for? You can sign up for any of the following categories.




WAIVER/RELEASE OF CLAIM

I hereby certify that I am physically fit and have no known medical condition(s) that would prohibit me from participating in this event. If female, I certify that I am not pregnant. I understand that I am solely responsible for any injury that I sustain as a result of my participation in this event. In consideration of my application to participate in the Polar Ice Plunge 2025 being accepted, I on behalf of myself and my estate, hereby waiver and forever discharge East Peoria Boat Club, the sponsors, organizers, affiliates, as well as their agents and employees from all claims that may accrue as a result of my participation.



Please Sign Below

Your electronic signature is the online equivalent of your ink-on-paper signature, and can be provided by typing your name where indicated. The electronic signature will signify your understanding, acceptance, and authorization to accept the conditions of this legal document, including the following statements:

  • I have read, have understood, and do accept the agreement above.
  • I understand that this is a legal document with effects that I approve and authorize.
  • The registrant is the person(s) whose name is submitted as the recipient of the goods and services provided as a result of this transaction.
  • I am authorized to agree to the terms of this document on behalf of the registrant.
  • If the registrant is under 18 years of age, incapacitated, or mentally challenged, I assert that I am the parent/legal guardian or otherwise authorized to execute a legally binding agreement on behalf of the registrant.

Electronic Signature

You must be 18 years of age to legally complete this registration. If the registrant is under 18, an authorized adult must complete this form.
If the person you are registering (registrant) is under 18, do not enter his/her age. You will do that on the next step. Enter your age here as the person completing the form.




Multiple signers should separate their signatures with commas.


This agreement was generated at 11:50:19 PM EDT on 10/17/2024.