Saturday, August 2, 2014 Captain s Cove Seaport, Bridgeport, CT. Two-Person Relay Application. Sponsored by:
|
|
- Patricia Allison
- 6 years ago
- Views:
Transcription
1 The St. Vincent s SWIM Acrss the Sund Marathn Saturday, August 2, 2014 Captain s Cve Seaprt, Bridgeprt, CT Tw-Persn Relay Applicatin Spnsred by:
2 SWIM MARATHON RULES & GUIDELINES TWO-PERSON RELAY SWIMMERS 1. CLOTHING: One suit, swim cap, gggles, earplugs and grease will be allwed. Fr wmen, suits that cver up t their neck and dwn t their knees are acceptable. Fr men, suits may nt cver their trs, nr g belw their knees. Neither men nr wmen may wear suits that cver their shulders in any way. All suits must be f the traditinal swimming style lycra type suits. Swimmers must wear the prvided swim cap. 2. ASSISTANCE: Tw-persn relay swimmers may nt use fltatin aids, prpulsin devices, r any ther devices t maintain bdy heat. Wetsuits, fins, hand paddles, pull buys r bards are strictly prhibited. Pacing, drafting and twing are nt allwed. Swimmers may nt tuch the escrt bat r any ther bat during the SWIM. A vilatin f this rule shall result in disqualificatin. All tw-persn relay swimmers shuld bring ne crew member t prvide feeding assistance. If a swimmer is unable t bring their wn crew, please ntify the race cmmittee and we will use ur best effrts t prvide yu a crew member. Swimmers are required t bring their wn fd fr the swim. The use f alchl r drugs is strictly frbidden. 3. QUALIFYING SWIM: All tw-persn relay applicants must submit prf f a fur-hur r lnger qualifying swim in pen water cmpleted within the past 18 mnths in rder t be eligible t participate in the event. Swimmers wh have successfully cmpleted any f the fllwing swims within the past 18 mnths are exempt frm the fur-hur qualifier swim: Catalina Island Channel SWIM Acrss the Sund English Channel Tampa Bay 24 mile Marathn Swim Lake Memphremagg Fur-Hur Qualifying Swim* Manhattan Island Marathn Swim Other USA/USMS distance swim > 10 miles Rund Jersey Swim (Channel Islands) * Please cmplete and submit the Qualifying Swim-Observer Reprrt and Qualifying Lg. Applicants must submit this requirement by the dcumentatin deadline. 4. AGE MINIMUM: Tw-persn relay swimmers must be 19 years ld n r befre December 31 f the year f the event, in accrdance with FINA Age Rules. Exceptins may be cnsidered under the discretin f the SWIM Cmmittee. 5. TWO-PERSON RELAY INSTRUCTIONS: Swimmers must alternate every 30 minutes (n exceptins). The rder f the swimmers must be maintained thrughut the swim. The transitin frm ne swimmer t the next must be executed by appraching the swimmer in the water frm behind, and the transitin is cnsidered cmplete when the entering swimmer fully passes the departing swimmer. Relay team members must enter the water feet first. Failure t fllw these rules will result in disqualificatin. 6. MEDICAL EXAMINATION: Bth swimmers must have their primary physician fully cmplete the required medical frm. Tw-Persn Relay Applicatin - Rules & Guidelines Page 1 f 1
3 INSTRUCTIONS FOR RELAY TEAM CAPTAINS BEFORE YOU START If yu have previusly participated in the SWIM Marathn (r since 2007), please use yur existing User ID and passwrd If yu have nt previusly participated in the SWIM Marathn, please cntinue with the nline registratin prcess. It will allw yu t create a new user ID and passwrd Make sure yu have the full legal name (NO nicknames) and addresses f yur team members REGISTRATION IS A THREE STEP PROCESS 1. Cmplete the nline Registratin Frm 2. Print, cmplete and sign the Applicatin Frm 3. After the Team Captain has cmpleted the nline Applicatin Prcess, a cmputer generated will be sent t the team members with a link t prmpt them t register. In additin t registering nline, team members must als print, cmplete and sign the team member prtin f the written applicatin HOW TO COMPLETE THE ONLINE REGISTRATION FORM Register by inputting the fllwing: Cntact infrmatin Accunt Infrmatin Accident and Release f Liability Waiver Accept Waiver bx must be checked Jin Optins Click n Create a New Team Set Team Gal Enter dllar amunt in bx (Relay team gal is $7,500) Create the Team Type click n Relay Team frm the pull dwn Input New Team Name Event Optins There can nly be ne Team Captain whether they are swimming r nn-swimming Team Captain (Relays) bx input 1 frm the pull dwn If yu re a Team Captain wh is swimming 5 team members can be input If yu re a Team Captain wh is nt swimming 6 team members can be input Tw-Persn Relay Applicatin - Team Captain Page 1 f 4
4 INSTRUCTIONS FOR RELAY TEAM CAPTAINS Payment Verify billing infrmatin Enter payment infrmatin A nn-refundable entry fee payment f $200 is due with the applicatin submitted by a sl swimmer r team captain. This amunt will be included in yur fundraising gal Click Register Cnfirmatin Team Captain will receive cnfirmatin f a successful registratin An message will be sent t each team member with a website link t take them t relay team member registratin. Each team member shuld cmplete the nline registratin. Team Captains must then dwnlad, print, cmplete and sign the Applicatin Frm (Offline Frm) My Dashbard Click n My Team Click n Add New Team Member Input the full legal names (NO nicknames) and addresses f the team members - One additinal team member may be added t teams with nn-swimming team captains. Set up a team page with infrmatin and pictures HOW TO COMPLETE THE PAPER APPLICATION FORM Click n this link: Click n Team Relay Swimmer Applicatin Print, cmplete and sign applicatin (this is an ffline, paper applicatin) , fax r mail the cmpleted frm t: PFignar@stvincents.rg AND SwimAcrssTheSund.Sharn@gmail.rg Fax (203) Mail t: St. Vincent s Medical Center Fundatin Attn: Patti Fignar 2800 Main Street Bridgeprt, CT a high-reslutin (300 dpi) digital pht t: Debrah.Cx@stvincents.rg Please ensure that the security settings n yur prgram allw incming mail frm senders at LizFry.MarathnDirectr@SwimAcrssTheSund.rg, dcards@stvincents.rg, debrah.cx@stvincents.rg, pfignar@stvincents.rg, eafry@al.cm, SwimAcrssTheSund.Sharn@gmail.rg. Tw-Persn Relay Applicatin - Team Captain Page 2 f 4
5 TEAM CAPTAIN TWO-PERSON RELAY APPLICATION TEAM INFORMATION (T be cmpleted by Team Captain.) Please nte: Use full legal name (n nicknames r abbreviatins). Team Name: Team Captain r Cach Name: Captain/Cach Phne: Captain/Cach Swimmer #1 Age*: Swimmer #2 Age*: In rder t keep the flw f infrmatin cnsistent and accurate, any questins r infrmatin needs by team members shuld be cmmunicated by the Captain r Cach t the SWIM Cmmittee. Are yu representing a club, rganizatin r crpratin? If yes, please explain! Acknwledgement f Cmmitment I acknwledge and understand that cmpeting in such an event is an extreme test f each team member s swimming ability, mental tughness and physical cnditining. I have selected the team members with these cnditins in mind and believe that each team member is physically fit and capable f swimming in this event. I als acknwledge that the fundraising cmmitment fr the team is $3,500 and that the team is cmmitted t reaching and hpefully exceeding this gal. Team Captain Date *Day f SWIM Tw-Persn Relay Applicatin - Team Captain Page 3 f 4
6 TEAM CAPTAIN TWO-PERSON RELAY APPLICATION - CREW INFORMATION TO BE COMPLETED BY TEAM CAPTAIN Use full legal name (n nicknames r abbreviatins). Team Name: CREW #1 Name: Address: City, State, Zip Phne: Wrk Phne: Cell Phne: Is Cell available n race day? Relatinship/Age: T-shirt Size: Is crew member a certified lifeguard? Yes N Is crew member a certified EMT? Yes N CREW #2 (ALTERNATE) Name: Address: City, State, Zip Phne: Wrk Phne: Cell Phne: Is Cell available n race day? Relatinship/Age: T-shirt Size: Is crew member a certified lifeguard? Yes N Is crew member a certified EMT? Yes N Crew members and alternates will receive an with instructins n crew enrllment nce the sl swimmers r team has been accepted fr the SWIM. Crew members and alternates must cnfirm participatin by cmpleting the crew member s enrllment and waiver. Tw-Persn Relay Applicatin - Team Captain Page 4 f 4
7 SWIMMER #1 TWO-PERSON RELAY APPLICATION PERSONAL INFORMATION Use full legal name (n nicknames r abbreviatins). Team Name: Team Captain: Swimmer #1 Full Legal Name: Address: City, State, Zip, Cuntry Hme Phne: Cell Phne: Cntact Gender: DOB: (mm/dd/yy) Age: T-shirt size: Height: Weight: Please nte: yur name, age, hmetwn and backgrund infrmatin may be used fr media relatins and prmtinal purpses. Yur cntact infrmatin may be used t reach yu fr media inquiries, but will never be published withut yur granted cnsent. WORK INFORMATION Occupatin & Title: Emplyer: Emplyer Address: City, State, Zip Cuntry Phne: Fax: Des Yur Emplyer Match Charitable Dnatins? Yes N EMERGENCY CONTACT INFORMATION Name: Hme Phne: Relatinship: Cell Phne: Tw-Persn Relay Applicatin - Swimmer #1 Page 1 f 8
8 SWIMMER #1 TWO-PERSON RELAY APPLICATION ACCIDENT AND RELEASE OF LIABILITY WAIVER I acknwledge that this 25km athletic event is an extreme test f a persn s physical and mental limits and hereby certify that I am physically fit and have nt been therwise infrmed by a physician. I acknwledge that I am aware f all f the risks inherent in Open Water Swimming (training and cmpetitin), including pssible permanent disability r death, and agree t assume all thse risks. I acknwledge that this Accident and Release f Liability Waiver will be used by the event hlders, spnsrs and rganizers f the event f the SWIM Acrss the Sund, and that it will gvern my actins and respnsibilities at such event. AS A CONDITION OF MY PARTICIPATION IN THE SWIM ACROSS THE SOUND OR ANY ACTIVITIES INCIDENT THERETO, I HEREBY WAIVE ANY AND ALL RIGHTS TO CLAIMS FOR LOSS OR DAMAGES, INCLUDING ALL CLAIMS FOR LOSS OR DAMAGES CAUSED BY THE NEGLIGENCE, ACTIVE OR PASSIVE, OF THE FOLLOWING: ST. VINCENT S HEALTH SERVICES, ST. VINCENT S MEDICAL CENTER, ST. VINCENT S MEDICAL CENTER FOUNDATION, SWIM ACROSS THE SOUND, CITY OF BRIDGEPORT, CAPTAINS COVE MARINA, DANFORDS MARINA, ALL PARTICIPATING POLICE AND FIRE DEPTS FROM VARIOUS TOWNS, STATES OF CT AND NY, HOST FACILITIES, EVENT SPONSORS, VOLUNTEERS, BOAT CAPTAINS, EVENT COMMITTEES, OR ANY INDIVIDUALS OFFICIATING AT THE EVENTS OR SUPERVISING SUCH ACTIVITIES. In additin, I als agree t abide by and be gverned by the rules established by the SWIM Cmmittee. Finally, I specifically acknwledge that I am aware f all the risks inherent in pen water swimming and agree t assume thse risks. Print Swimmer s Full Legal Name Age Signature Date If Swimmer is under the Age f 19, signature f parent r guardian is als required. Print Parent/Guardian Name Age Signature f Parent r Guardian Date Tw-Persn Relay Applicatin - Swimmer #1 Page 2 f 8
9 SWIMMER #1 TWO-PERSON RELAY APPLICANT - QUALIFYING SWIM Swimmer #1 Full Legal Name: Each Tw-Persn Relay applicant must submit prf f a fur-hur r lnger qualifying swim in pen water cmpleted within 18 mnths f the event t be eligible t participate. Number f marathn swims Qualifying Swim Catalina Island Channel English Channel Lake Memphremagg Manhattan Island Marathn Swim Rund Jersey Swim SWIM Acrss the Sund (sl) Tampa Bay 24 mile Marathn Swim Fur-hur Qualifying Swim* Other USA/USMS distance swim (>10 miles) Time - Date (please enter Pending if nt cmpleted at time f applicatin) * Please cmplete and submit the Qualifying Swim Observer Reprt and Qualifying Swim Lg. Applicants must submit this requirement by the dcumentatin deadline. Fur-hur Qualifying Swim shuld be fur hurs f cntinuus swimming, with in-water feedings (if at all pssible) t try t duplicate the rutine yu will encunter in SAS. Yu shuld try t have a few peple with yu in rder t assist in this qualifying swim s they can keep yur lg and help yu with the feedings. Yu may als have ther swimmers accmpany yu n this swim and can g as fast r slw as yu desire. An example f a qualifying swim lg is enclsed in this packet. After cmpletin f yur qualifying swim, yur bserver shuld submit the frm belw n yur behalf. If yu are exempt frm a Fur-hur Qualifying Swim, please submit cpies f fficial race results r ther dcumentatin frm ne f the ther events abve. OBSERVER NAME: ADDRESS: PHONE / QUALIFYING SWIM - OBSERVER REPORT I, attest that swam cntinuusly fr fur hurs n, at beach lcated in the city f in the state f. Based upn this swim, I believe he/she is qualified t cmpete in the SWIM Acrss the Sund. I have attached a lg frm his qualifying swim. Signed Signature Tw-Persn Relay Applicatin - Swimmer #1 Page 3 f 8
10 SWIMMER #1 TWO-PERSON RELAY APPLICATION - MEDICAL FORM Swimmer #1 Full Legal Name: DOB: Parts 1 & 2 must be cmpleted and enclsed with yur applicatin. INCOMPLETE MEDICAL FORMS WILL CAUSE YOUR APPLICATION TO BE DELAYED OR REJECTED. If yu answer yes t any questins, yu must prvide an explanatin n the back f this frm. PART I: MEDICAL HISTORY (t be cmpleted by Swimmer) 1. Have yu ever suffered at any time frm the fllwing: a. Ear truble, earache r deafness? YES NO b. Sinus truble? YES NO c. Chest disease, including asthma, brnchitis, TB, cllapse lung? YES NO d. Blackuts r fainting? YES NO e. Nervus disrders, cncussins? YES NO f. Anxiety, nerves r nervus breakdwns? YES NO g. Heart Disease? YES NO h. High Bld Pressure? YES NO i. Diabetes? YES NO 2. D yu regularly r frequently take medicatins with r withut prescriptin? YES NO 3. Are yu currently receiving medical care r cnsulted a dctr in the last year? YES NO 4. Have yu ever failed a medical exam r been refused life insurance? YES NO 5. Have yu been t the hspital in the last year? YES NO 6. D yu smke r use illegal drugs? YES NO 7. D yu have any allergies t medicatin? YES NO 8. D yu have any rthpedic prblems? YES NO 9. D yu wear any prstheses? YES NO I certify that t the best f my knwledge, I am in gd health and that I have nt mitted any infrmatin which may be relevant t my fitness t swim. I authrize my medical dctr t disclse any detail f my past r present medical histry if requested t d s by the SWIM cmmittee r applicatin review panel. Signed: Date: PART II: DOCTOR S EXAMINATION The abve named swimmer wishes t be examined t determine his/her physical fitness t participate in a 25km SWIM Acrss Lng Island Sund. Please nte that this is an extreme test f physical and mental endurance. Height: Weight: Bld Pressure: Pulse: Ears: R. Drum: R. Canal: L. Drum: L. Canal: Sinuses: Nse: Thrat: Chest: Cardi Sys: Nervus Sys: Jints: Limbs: ECG: Urine-Albumin Urine-Glucse: NOTE: The Swim encurages and welcmes swimmers with disabilities. REMARKS: Any remarks abut the swimmers physical cnditin shuld be written n the back f this frm. AFTER EXAMINATION, I CONSIDER (print swimmer name) TO BE FIT r UNFIT t participate in this SWIM. Examining Dctr Print Name SIGN DATE Tw-Persn Relay Applicatin - Swimmer #1 Page 4 f 8
11 SWIMMER #1 TWO-PERSON RELAY APPLICATION - PERSONAL STORY Swimmer #1 Full Legal Name: Have yu ever participated in the SWIM Acrss the Sund? Yes N If yes, when? What is yur persnal fundraising gal? (The minimum fundraising cmmitment is $3,500) $ What made yu interested t participate in the SWIM? Are yu swimming in hnr f smene? Any ther infrmatin yu wuld like t share? Tw-Persn Relay Applicatin - Swimmer #1 Page 5 f 8
12 SWIMMER #1 TWO-PERSON RELAY APPLICATION - SWIMMING BACKGROUND Swimmer #1 Full Legal Name: Each Tw-Persn Relay applicant must have cmpleted a fur-hur r lnger qualifying swim. Prf must be submitted by the dcumentatin deadline. PLEASE LIST SOME OF YOUR MOST RECENT OPEN WATER EVENTS: (attach dcumentatin) Event Name: Lcatin/Distance: Date: Finishing Time: Water Temp: Winner Finish Time: What was yur place? Event Name: Lcatin/Distance: Date: Finishing Time: Water Temp: Winner Finish Time: What was yur place? Event Name: Lcatin/Distance: Date: Finishing Time: Water Temp: Winner Finish Time: What was yur place? Event Name: Lcatin/Distance: Date: Finishing Time: Water Temp: Winner Finish Time: What was yur place? OPEN WATER SWIMS PLANNED FOR CURRENT YEAR: Swim #1 Lcatin: Distance: Swim #2 Lcatin: Distance: Swim #3 Lcatin: Distance: OTHER ATHLETIC ACHIEVEMENTS: PHOTO: Please a high-reslutin (300 dpi) pht f yurself t Debrah.Cx@stvincents.rg alng with yur first and last name. We may use this fr the lcal media and prmtinal materials. Tw-Persn Relay Applicatin - Swimmer #1 Page 6 f 8
13 SWIMMER #1 QUALIFYING SWIM LOG - PAGE 1 USE FULL LEGAL NAMES (NO NICKNAMES OR ABBREVIATIONS). Swimmer #1 Name: Date: Start Time: START: Air Temp and Cnditins: Water Temp and Cnditins: Swimmer s Mental and Physical Cnditins: Feeding Schedule (Interval/Liquid Type/Gel): Lcatin f Swim: Observer: Finish Time: ACTUAL TIME: HOUR 1: Air Temp and Cnditins: Water Temp and Cnditins: Swimmer s Mental and Physical Cnditins: Feeding: Strke rate per minute: ACTUAL TIME: HOUR 2: Air Temp and Cnditins: Water Temp and Cnditins: Swimmer s Mental and Physical Cnditins: Feeding: Strke rate per minute: ACTUAL TIME: HOUR 3: Air Temp and Cnditins: Water Temp and Cnditins: Swimmer s Mental and Physical Cnditins: Feeding: Strke rate per minute: ACTUAL TIME: Tw-Persn Relay Applicatin - Swimmer #1 Page 7 f 8
14 SWIMMER #1 QUALIFYING SWIM LOG - PAGE 2 Swimmer #1 Full Legal Name: HOUR 4: Air Temp and Cnditins: Water Temp and Cnditins: Swimmer s Mental and Physical Cnditins: Feeding: Strke rate per minute: ACTUAL TIME: Ttal time f the Swim COMMENTS: Tw-Persn Relay Applicatin - Swimmer #1 Page 8 f 8
15 SWIMMER #2 TWO-PERSON RELAY APPLICATION PERSONAL INFORMATION Use full legal name (n nicknames r abbreviatins). Team Name: Team Captain: Swimmer #2 Full Legal Name: Address: City, State, Zip, Cuntry Hme Phne: Cell Phne: Cntact Gender: DOB: (mm/dd/yy) Age: T-shirt size: Height: Weight: Please nte: yur name, age, hmetwn and backgrund infrmatin may be used fr media relatins and prmtinal purpses. Yur cntact infrmatin may be used t reach yu fr media inquiries, but will never be published withut yur granted cnsent. WORK INFORMATION Occupatin & Title: Emplyer: Emplyer Address: City, State, Zip Cuntry Phne: Fax: Des Yur Emplyer Match Charitable Dnatins? Yes N EMERGENCY CONTACT INFORMATION Name: Hme Phne: Relatinship: Cell Phne: Tw-Persn Relay Applicatin - Swimmer #2 Page 1 f 8
16 SWIMMER #2 TWO-PERSON RELAY APPLICATION ACCIDENT AND RELEASE OF LIABILITY WAIVER I acknwledge that this 25km athletic event is an extreme test f a persn s physical and mental limits and hereby certify that I am physically fit and have nt been therwise infrmed by a physician. I acknwledge that I am aware f all f the risks inherent in Open Water Swimming (training and cmpetitin), including pssible permanent disability r death, and agree t assume all thse risks. I acknwledge that this Accident and Release f Liability Waiver will be used by the event hlders, spnsrs and rganizers f the event f the SWIM Acrss the Sund, and that it will gvern my actins and respnsibilities at such event. AS A CONDITION OF MY PARTICIPATION IN THE SWIM ACROSS THE SOUND OR ANY ACTIVITIES INCIDENT THERETO, I HEREBY WAIVE ANY AND ALL RIGHTS TO CLAIMS FOR LOSS OR DAMAGES, INCLUDING ALL CLAIMS FOR LOSS OR DAMAGES CAUSED BY THE NEGLIGENCE, ACTIVE OR PASSIVE, OF THE FOLLOWING: ST. VINCENT S HEALTH SERVICES, ST. VINCENT S MEDICAL CENTER, ST. VINCENT S MEDICAL CENTER FOUNDATION, SWIM ACROSS THE SOUND, CITY OF BRIDGEPORT, CAPTAINS COVE MARINA, DANFORDS MARINA, ALL PARTICIPATING POLICE AND FIRE DEPTS FROM VARIOUS TOWNS, STATES OF CT AND NY, HOST FACILITIES, EVENT SPONSORS, VOLUNTEERS, BOAT CAPTAINS, EVENT COMMITTEES, OR ANY INDIVIDUALS OFFICIATING AT THE EVENTS OR SUPERVISING SUCH ACTIVITIES. In additin, I als agree t abide by and be gverned by the rules established by the SWIM Cmmittee. Finally, I specifically acknwledge that I am aware f all the risks inherent in pen water swimming and agree t assume thse risks. Print Swimmer s Full Legal Name Age Signature Date If Swimmer is under the Age f 19, signature f parent r guardian is als required. Print Parent/Guardian Name Age Signature f Parent r Guardian Date Tw-Persn Relay Applicatin - Swimmer #2 Page 2 f 8
17 SWIMMER #2 Swimmer #2 Full Legal Name: TWO-PERSON RELAY APPLICANT - QUALIFYING SWIM Each Tw-Persn Relay applicant must submit prf f a fur-hur r lnger qualifying swim in pen water cmpleted within 18 mnths f the event t be eligible t participate. Number f marathn swims Qualifying Swim Catalina Island Channel English Channel Lake Memphremagg Manhattan Island Marathn Swim Rund Jersey Swim SWIM Acrss the Sund (sl) Tampa Bay 24 mile Marathn Swim Fur-hur Qualifying Swim* Other USA/USMS distance swim (>10 miles) Time - Date (please enter Pending if nt cmpleted at time f applicatin) * Please cmplete and submit the Qualifying Swim Observer Reprt and Qualifying Swim Lg. Applicants must submit this requirement by the dcumentatin deadline. Fur-hur Qualifying Swim shuld be fur hurs f cntinuus swimming, with in-water feedings (if at all pssible) t try t duplicate the rutine yu will encunter in SAS. Yu shuld try t have a few peple with yu in rder t assist in this qualifying swim s they can keep yur lg and help yu with the feedings. Yu may als have ther swimmers accmpany yu n this swim and can g as fast r slw as yu desire. An example f a qualifying swim lg is enclsed in this packet. After cmpletin f yur qualifying swim, yur bserver shuld submit the frm belw n yur behalf. If yu are exempt frm a Fur-hur Qualifying Swim, please submit cpies f fficial race results r ther dcumentatin frm ne f the ther events abve. OBSERVER NAME: ADDRESS: PHONE / QUALIFYING SWIM - OBSERVER REPORT I, attest that swam cntinuusly fr fur hurs n, at beach lcated in the city f in the state f. Based upn this swim, I believe he/she is qualified t cmpete in the SWIM Acrss the Sund. I have attached a lg frm his qualifying swim. Signed Signature Tw-Persn Relay Applicatin - Swimmer #2 Page 3 f 8
18 SWIMMER #2 TWO-PERSON RELAY APPLICATION - MEDICAL FORM Swimmer #2 Full Legal Name: DOB: Parts 1 & 2 must be cmpleted and enclsed with yur applicatin. INCOMPLETE MEDICAL FORMS WILL CAUSE YOUR APPLICATION TO BE DELAYED OR REJECTED. If yu answer yes t any questins, yu must prvide an explanatin n the back f this frm. PART I: MEDICAL HISTORY (t be cmpleted by Swimmer) 1. Have yu ever suffered at any time frm the fllwing: a. Ear truble, earache r deafness? YES NO b. Sinus truble? YES NO c. Chest disease, including asthma, brnchitis, TB, cllapse lung? YES NO d. Blackuts r fainting? YES NO e. Nervus disrders, cncussins? YES NO f. Anxiety, nerves r nervus breakdwns? YES NO g. Heart Disease? YES NO h. High Bld Pressure? YES NO i. Diabetes? YES NO 2. D yu regularly r frequently take medicatins with r withut prescriptin? YES NO 3. Are yu currently receiving medical care r cnsulted a dctr in the last year? YES NO 4. Have yu ever failed a medical exam r been refused life insurance? YES NO 5. Have yu been t the hspital in the last year? YES NO 6. D yu smke r use illegal drugs? YES NO 7. D yu have any allergies t medicatin? YES NO 8. D yu have any rthpedic prblems? YES NO 9. D yu wear any prstheses? YES NO I certify that t the best f my knwledge, I am in gd health and that I have nt mitted any infrmatin which may be relevant t my fitness t swim. I authrize my medical dctr t disclse any detail f my past r present medical histry if requested t d s by the SWIM cmmittee r applicatin review panel. Signed: Date: PART II: DOCTOR S EXAMINATION The abve named swimmer wishes t be examined t determine his/her physical fitness t participate in a 25km SWIM Acrss Lng Island Sund. Please nte that this is an extreme test f physical and mental endurance. Height: Weight: Bld Pressure: Pulse: Ears: R. Drum: R. Canal: L. Drum: L. Canal: Sinuses: Nse: Thrat: Chest: Cardi Sys: Nervus Sys: Jints: Limbs: ECG: Urine-Albumin Urine-Glucse: NOTE: The Swim encurages and welcmes swimmers with disabilities. REMARKS: Any remarks abut the swimmers physical cnditin shuld be written n the back f this frm. AFTER EXAMINATION, I CONSIDER (print swimmer name) TO BE FIT r UNFIT t participate in this SWIM. Examining Dctr Print Name SIGN DATE Tw-Persn Relay Applicatin - Swimmer #2 Page 4 f 8
19 SWIMMER #2 TWO-PERSON RELAY APPLICATION - PERSONAL STORY Swimmer #2 Full Legal Name: Have yu ever participated in the SWIM Acrss the Sund? Yes N If yes, when? What is yur persnal fundraising gal? (The minimum fundraising cmmitment is $3,500) $ What made yu interested t participate in the SWIM? Are yu swimming in hnr f smene? Any ther infrmatin yu wuld like t share? Tw-Persn Relay Applicatin - Swimmer #2 Page 5 f 8
20 SWIMMER #2 TWO-PERSON RELAY APPLICATION - SWIMMING BACKGROUND Swimmer #2 Full Legal Name: Each Tw-Persn Relay applicant must have cmpleted a fur-hur r lnger qualifying swim. Prf must be submitted by the dcumentatin deadline. PLEASE LIST SOME OF YOUR MOST RECENT OPEN WATER EVENTS: (attach dcumentatin) Event Name: Lcatin/Distance: Date: Finishing Time: Water Temp: Winner Finish Time: What was yur place? Event Name: Lcatin/Distance: Date: Finishing Time: Water Temp: Winner Finish Time: What was yur place? Event Name: Lcatin/Distance: Date: Finishing Time: Water Temp: Winner Finish Time: What was yur place? Event Name: Lcatin/Distance: Date: Finishing Time: Water Temp: Winner Finish Time: What was yur place? OPEN WATER SWIMS PLANNED FOR CURRENT YEAR: Swim #1 Lcatin: Distance: Swim #2 Lcatin: Distance: Swim #3 Lcatin: Distance: OTHER ATHLETIC ACHIEVEMENTS: PHOTO: Please a high-reslutin (300 dpi) pht f yurself t Debrah.Cx@stvincents.rg alng with yur first and last name. We may use this fr the lcal media and prmtinal materials. Tw-Persn Relay Applicatin - Swimmer #2 Page 6 f 8
21 SWIMMER #2 QUALIFYING SWIM LOG - PAGE 1 USE FULL LEGAL NAMES (NO NICKNAMES OR ABBREVIATIONS). Swimmer #2 Name: Date: Start Time: START: Air Temp and Cnditins: Water Temp and Cnditins: Swimmer s Mental and Physical Cnditins: Feeding Schedule (Interval/Liquid Type/Gel): Lcatin f Swim: Observer: Finish Time: ACTUAL TIME: HOUR 1: Air Temp and Cnditins: Water Temp and Cnditins: Swimmer s Mental and Physical Cnditins: Feeding: Strke rate per minute: ACTUAL TIME: HOUR 2: Air Temp and Cnditins: Water Temp and Cnditins: Swimmer s Mental and Physical Cnditins: Feeding: Strke rate per minute: ACTUAL TIME: HOUR 3: Air Temp and Cnditins: Water Temp and Cnditins: Swimmer s Mental and Physical Cnditins: Feeding: Strke rate per minute: ACTUAL TIME: Tw-Persn Relay Applicatin - Swimmer #2 Page 7 f 8
22 SWIMMER #2 QUALIFYING SWIM LOG - PAGE 2 Swimmer #2 Full Legal Name: HOUR 4: Air Temp and Cnditins: Water Temp and Cnditins: Swimmer s Mental and Physical Cnditins: Feeding: Strke rate per minute: ACTUAL TIME: Ttal time f the Swim COMMENTS: Tw-Persn Relay Applicatin - Swimmer #2 Page 8 f 8
Solo Swimmer Application
The St. Vincent s SWIM Across the Sound Marathon Saturday, August 1, 2009 Captain s Cove Marina Bridgeport, CT Solo Swimmer Application Sponsored by: St. Vincent s Medical Center Foundation (203) 576-5451
More informationSWIM Across the Sound Marathon
St. Vincent s SWIM Across the Sound Marathon August 5 th, 2017 Captain s Cove Seaport, Bridgeport, CT TWO-PERSON RELAY APPLICATION SWIM MARATHON RULES & GUIDELINES TWO-PERSON RELAY SWIMMERS 1. PARTICIPATION:
More informationTeam Relay Application
The St. Vincent s SWIM Across the Sound Marathon Saturday, August 2, 2014 Captain s Cove Seaport, Bridgeport, CT Team Relay Application CLASSIC (NO WETSUIT ALLOWED) Sponsored by: SWIM MARATHON RULES &
More informationRelay Team Swimmer Application
The St. Vincent s SWIM Across the Sound Marathon Saturday, August 1, 2009 Captain s Cove Marina Bridgeport, CT Relay Team Swimmer Application Sponsored by: St. Vincent s Medical Center Foundation (203)
More informationSWIM Across the Sound Marathon
St. Vincent s SWIM Across the Sound Marathon August 4th, 2018 Captain s Cove Seaport, Bridgeport, CT TEAM RELAY APPLICATION Traditional (wetsuits allowed) Hope has no finish line. SWIM MARATHON RULES &
More informationSWIM Across the Sound Marathon
St. Vincent s SWIM Across the Sound Marathon August 5th, 2017 Captain s Cove Seaport, Bridgeport, CT TEAM RELAY APPLICATION University Challenge SWIM MARATHON RULES & GUIDELINES TEAM RELAY UNIVERSITY CHALLENGE
More informationSWIM Across the Sound Marathon
St. Vincent s SWIM Across the Sound Marathon August 3 rd, 2019 Captain s Cove Seaport, Bridgeport, CT TEAM RELAY APPLICATION Corporate Challenge SWIM MARATHON RULES & GUIDELINES TEAM RELAY CORPORATE CHALLENGE
More informationUCP of Central MN STUCK IN MOTION STATIONARY. bike race. January. 27 Saturday PARTICIPANT PACKET
UCP f Central MN STUCK IN MOTION STATIONARY bike race 2018 January 27 Saturday PARTICIPANT PACKET STUCK IN MOTION RIDER Dear Team Member: Thank yu fr jining ur team and supprting UCP s Stuck In Mtin bike
More informationUSTA Atlanta Combo Doubles Registration Information Play begins in late April
Serving Cbb, Fultn, Dekalb, Gwinnett and Frsyth cunties USTA Atlanta Cmb Dubles Registratin Infrmatin Play begins in late April Spring 2011 League Infrmatin and Dates NEW! Team Match Frmat: Each team match
More informationUCP of Central MN STUCK IN MOTION STATIONARY. bike race. January. 27 Saturday
UCP f Central MN STUCK IN MOTION STATIONARY bike race 2018 January 27 Saturday STUCK IN MOTION CAPTAIN The SIM cmmittee vlunteers and all f us at UCP f Central MN (United Cerebral Palsy) sincerely appreciate
More informationCANTERBURY CRICKET CLUB INTRODUCTORY LETTER TO PARENTS
CANTERBURY CRICKET CLUB INTRODUCTORY LETTER TO PARENTS Dear Parent, Guardian r Carer, On behalf f Canterbury Cricket Club I wuld like t welcme yur child t the club and prvide yu with sme infrmatin abut
More informationDates: May 4-6, 2018 Times: 6-9pm 9am Location: UTSA Convocation Center One UTSA Circle, San Antonio, TX Tryout Fee: $45.00
2018-2019 Seasn University f Texas at San Antni Cheerleading Tryut Infrmatin Packet Welcme t University f Texas at San Antni. Thank yu fr yur interest in the UTSA Spirit Prgram. We encurage everyne t read
More informationIf you have any questions please contact us at the (preferred) or numbers below.
JULY 16, 2017 Thank yu fr yur interest in ur 2017 Parade, Attached is ur 2017 Grand Parade Applicatin fr Sunday, July 16th. The PDF: 2017 KCD Parade App can be filled ut n yur cmputer r printed and filled-ut.
More informationJUNETEENTHKC PARADE 2018 KANSAS CITY, MISSOURI
JUNETEENTHKC PARADE 2018 KANSAS CITY, MISSOURI Parade Participant: JuneteenthKC crdially invites yu t participate in the Juneteenth Parade in Kansas City, Missuri, Saturday, June 2, 2018. Participating
More informationAsessippi Ski Trip Packing List
Asessippi Ski Trip Packing List These items are a suggested list f items t bring. Items are brken dwn int 2 bags; 1 bag fr the htel and 1 bag fr the ski hill. Htel Bag Dry clthing Scks Pants Shirt Sweater
More informationGIRLS ON THE RUN NYC 5k JUNE 4, 2017 VOLUNTEER HANDBOOK
GIRLS ON THE RUN NYC 5k JUNE 4, 2017 VOLUNTEER HANDBOOK Page 2 Event Details Page 3.5k Vlunteer Descriptins Page 4-5..Vlunteer FAQs Please nte the Firefighters Field Map can be viewed at gtrnyc.rg/5kinf
More informationSENIOR STARS HOCKEY LEAGUE
SENIOR STARS HOCKEY LEAGUE 2014 SUMMER SEASON June - September 2013 The Senir Stars Hckey League (SSHL), the fficial adult hckey league f the Dallas Stars, is ready t light the lamp fr its 2014 summer
More informationAlpine Guide TAP APPLICATION PACKAGE. Hello and thank you for your interest in applying to the ACMG Training and Assessment Program (TAP).
Hell and thank yu fr yur interest in applying t the ACMG Training and Assessment Prgram (TAP). As f April 30, 2018, the ACMG will be running the prgram fr an undetermined perid. Fr any curses beginning
More informationINSTRUCTIONS Sanctioning a 3PAR Competition
INSTRUCTIONS Sanctining a 3PAR Cmpetitin The Natinal Three-Psitin Air Rifle Cuncil sanctins three-psitin air rifle matches t 1) fficially recgnize cmpetitins cnducted under the Natinal Standard Three-Psitin
More information2017 Chili Bowl Classic 5k. FAQ s. About the Race
2017 Chili Bwl Classic 5k FAQ s Abut the Race When des the race begin? The race will begin at 9:30 am n Saturday, February 25 th Where des the race begin? On St. Clair Avenue in frnt f the Galleria at
More informationGlide into Spring Beyond the Basics Figure Skating Club of Southern Maryland (FSCSM) Saturday, May 20, 2017
Glide int Spring Beynd the Basics Figure Skating Club f Suthern Maryland (FSCSM) Saturday, May 20, 2017 The Glide Int Spring Beynd the Basics cmpetitin will be cnducted in accrdance with the rules and
More informationValdosta Competition Cheerleading Tryouts
Valdsta Cmpetitin Cheerleading Tryuts Mnday, April 10, 2017- Thursday, April 13, 2017 4:00-6:00 All participants will meet in the VMS gym. Yu will need t be dressed ut in a t-shirt, athletic shrts, and
More informationRunning a Raffle. There are 3 types of Legal Wisconsin Raffles
Running a Raffle Thank yu fr yur interest in running a raffle t benefit United Way f Prtage Cunty. We knw that raffles make great special events. Raffles cnducted t benefit United Way f Prtage Cunty must
More informationSwim Around Lido Key Saturday, April 22, 2017 Race and Safety Plan
Swim Arund Lid Key Saturday, April 22, 2017 Race and Safety Plan This dcument utlines the details abut the race and safety plans fr ur 7-mile pen water race n Lid Key, Flrida. It cntains the fllwing: Race
More informationNATIONAL YOUTH SPORTS TACKLE FOOTBALL
TACKLE FOOTBALL PRE-SEASON COACH PACKET FALL 2017 SPRING 2018 FREQUENTLY ASKED QUESTIONS HOW CAN I GURANTEE A HEAD COACHING SPOT AND TEAM? The nly way t assure a head caching psitin and team is t enrll
More informationNORTH-EAST WALES NETBALL ASSOCIATION LEAGUE RULES
STATEMENT ORGANISATION & ADMINISTRATION The league shall be gverned and managed by the Nrth-East Wales Netball Assciatin cmmittee which may delegate its pwers and authrity in this respect t any sub-cmmittee
More informationGuidance on Exception Reporting for Educational and Clinical Supervisors and Leads
Guidance n Exceptin Reprting fr Educatinal and Clinical Supervisrs and Leads Exceptin Reprting is the mechanism used by dctrs t infrm the emplyer when their day-t day wrk varies significantly and/r regularly
More informationFriends Central Aquatics Fall Mini
Friends Central Aquatics Fall Mini Sunday Nvember 13th, 2011 Held under the sanctin f USA Swimming and Middle Atlantic Swimming Sanctin#: MA 1254 M MEET DIRECTOR: INQUIRIES: MEET LOCATION: Jim Turley:
More informationSpring Finale Meet Announcement
Spring Finale Meet Annuncement March 23-25, 2018 Sanctined by USA Swimming thrugh Ptmac Valley Swimming Meet Sanctin # PVI-18-68 Meet Directr: Christa Krukiel christa.krukiel@mntgmerycuntymd.gv (240) 777-8070
More informationSTEVENSON HIGH SCHOOL
STEVENSON HIGH SCHOOL GIRLS SWIMMING & DIVING TEAM HANDBOOK TABLE OF CONTENTS: - Intrductin & Histry p.3 - Team Missin & Gals p.3 Stevensn High Schl Patrit Girls Swimming & Diving Team - Caching Staff
More informationMISSOURI STATE 4-H COUNCIL REGIONAL REPRESENTATIVE APPLICATION
1 MISSOURI STATE 4-H COUNCIL REGIONAL REPRESENTATIVE APPLICATION The Missuri State 4-H Cuncil is an elected bdy f 4-H yuth wh serve fr ne year. Cuncil members help plan and carry ut State 4-H Cngress and
More informationNorthern Illinois Food Bank
Fr ffice use nly: Entered in Cmputer By Nrthern Illinis Fd Bank Curt-Cmpelled Individual (CCI) Frm Date Entered Date: Cntact Infrmatin (Required) Yes, I am ver 16 years ld (Date f Birth: (As a minr, please
More informationIAAF WORLD ATHLETICS CHAMPIONSHIPS DOHA, QAT 27 SEPTEMBER 6 OCTOBER 2019
IAAF WORLD ATHLETICS CHAMPIONSHIPS DOHA, QAT 27 SEPTEMBER 6 OCTOBER 2019 QUALIFICATION SYSTEM AND ENTRY STANDARDS (As apprved by the IAAF Cuncil in December 2018) AGE CATEGORIES Under 20 Athletes Under
More information2017 FREQUENTLY ASKED QUESTIONS
ASCENT PROGRAM QUESTIONS 2017 FREQUENTLY ASKED QUESTIONS 1. Q: Hw d I knw if I have cmpleted all requirements t receive ASCENT rewards? A: View yur ASCENT Mnthly Eligibility dashbard n the Fundatins site.
More informationTexas Intercity Football Inc.
Texas Intercity Ftball Inc. Texas Intercity Ftball Inc. (TIFI) was established in 1971 as a nn-prfit crpratin in rder t supprt the bys and girls within ur cmmunity. Currently there are 16 ftball clubs
More informationBrook Cricket Club Pirrie Hall, Haslemere Road, Brook, Surrey, GU8 5UJ
Brk Cricket Club Pirrie Hall, Haslemere Rad, Brk, Surrey, GU8 5UJ www.brkcricketclub.c.uk Safeguarding Children Plicy Guidelines n: 1. Transprt t and frm Matches and Training 2. Managing Children Away
More informationREGULATIONS. Version : June 2018 (subject to modifications) Regulations 2018 UCI Gran Fondo World Championships -1
REGULATIONS Versin : June 2018 (subject t mdificatins) Regulatins 2018 UCI Gran Fnd Wrld Champinships -1 Qualificatin Riders must qualify in ne f the UCI Gran Fnd Wrld Series qualifier events during the
More informationPresents Holiday Spectacular. Sunday, December 6, pm At Suburban Ice Macomb
& Presents 2015 Hliday Spectacular Sunday, December 6, 2015 3pm At Suburban Ice Macmb 2015 Hliday Spectacular Suburban Ice Macmb and the Onyx Suburban Skating Academy, will be hsting ur 12th Annual charity
More informationISLAND VIEW GOLF CLUB
ISLAND VIEW GOLF CLUB Dear Prspective Member, Thank yu fr yur recent interest in jining Island View Glf Club. We appreciate yur cnsideratin and we wuld like t extend t yu and yur family a special membership
More informationWho s Your School Breakfast Star? Writing Contest Official Rules
Wh s Yur Schl Breakfast Star? Writing Cntest Official Rules Abut the Writing Cntest As part f SNA s Natinal Schl Breakfast Week 2013, students will have the pprtunity write abut a special breakfast with
More informationKNOTHOLE BASEBALL, INC. AA Baseball 2019
KNOTHOLE BASEBALL, INC. AA Baseball 2019 MANAGERS MEETING: M a y 4 th, 10: 0 0 A M Blue Ash Sprts Cmplex(Crsley Field) *** T E A M R E G I S T R A T I O N *** The Team Registratin and rster frms alng with
More informationTFS Cheerleading Overview
TFS Cheerleading Overview A TF Suth Cheerleader is ne wh: Puts schl wrk first. Is a psitive rle mdel fr their team, schl, and cmmunity. Is present and n time at all events. Is cnsistently wrking n their
More informationSwim Centres Booking Application Form
Swim Centres Bking Applicatin Frm Please nte the Mlyneux Aquatic Centre and the Crmwell Swim Centre are smkefree. We ask that users f the facility respect this plicy fr the enjyment f all. PLEASE nte that
More informationENTRY STANDARDS. Approved by IAAF Council - March 2012 and November 2012
IAAF WORLD CHAMPIONSHIPS, MOSCOW 2013 10 AUGUST 18 AUGUST 2013 ENTRY STANDARDS Apprved by IAAF Cuncil - March 2012 and Nvember 2012 Men Wmen Event A Standard B Standard A Standard B Standard 10.15 10.21
More information87 th Atlantic City Pageant Ocean Swim Hosted by East Coast C-Cerpants Saturday, August 27, 2016 Atlantic City, NJ 08401
87 th Atlantic City Pageant Ocean Swim Hsted by East Cast C-Cerpants Saturday, August 27, 2016 Atlantic City, NJ 08401 ********************************* The Natin s ldest cntinuus Open Water Swimming race
More information2. For the tenth absence and all absences thereafter, a student s absences from school are considered excused for the following reasons:
6.004. Plicy Cncerning Schl Attendance and Truancy 6.004. Plicy Cncerning Schl Attendance and Truancy Cperative Educatinal Services (C.E.S.) believes that regular schl attendance is essential fr an effective
More informationSan Diego-Imperial Swimming 2014 Winter Age Group Championship December 20-22, 2014 Note: Updated 1 October 2014
Nte: Updated 1 Octber 2014 SANCTION: This meet is sanctined by USA Swimming and issued by San Dieg- Imperial Swimming #SI- 14-52. In granting this sanctin it is understd and agreed that USA Swimming shall
More informationNOCRA Newsletter. Breaking News. In this issue: Breaking News. President s Update. New Rating System. Treasurer s Update. Thank You for the Memories
NOCRA Newsletter September 2012 Breaking News Update Yur Arbiter There are still sme referees that dn t have a picture r phne number in Arbiter. Sme f yur pictures are questinable; please use a gd picture
More informationSOLE BURNER 5K WALK/RUN
SOLE BURNER 5K WALK/RUN Team Captain Kit SOLE BURNER Madisn Saturday, April 23, 2016 Warner Park, Madisn www.sleburner.rg/madisn ACS staff cntact: Miranda Knudsn at 608.662.7546 r Miranda.Knudsn@cancer.rg
More informationPublic School Choice EBR Guidance. North Banks Middle School
Public Schl Chice EBR Guidance Nrth Banks Middle Schl East Batn Ruge Parish Schl System Federal Prgrams, Title I Instructinal Resurce Center 1022 S. Fster Drive Batn Ruge, Luisiana 70806 Bernard Taylr,
More informationCANTERBURY CRICKET CLUB. Code of Conduct for Coaches, Club Officials & Volunteers
Cde f Cnduct fr Caches, Club Officials & Vlunteers Canterbury Junir Cricket has the fllwing Cde f Cnduct fr fficials, junir caches and vlunteers: All Canterbury Cricket Club Officials, Junir Caches and
More informationCompliance with CPD Regulations A General Guide to CPD
Cmpliance with CPD Regulatins A General Guide t CPD May 2017 Cntents CPD requirements 3 CPD definitin 3 Hw t calculate CPD hurs 3 Undertaking university curses 4 Training events 4 Calculatin f CPD hurs
More information2018 Dance Camp Chicago Rules
2018 Dance Camp Chicag Rules General All Cmpetitrs must purchase a weekend pass. Cstumes are strngly discuraged (thugh crdinating apparel is allwed), and bts and hats are nt required. Dance Camp will prvide
More informationTELUS WISE footprint comic contest Create your own comic strip and enter for a chance to win
TELUS WISE ftprint cmic cntest Create yur wn cmic strip and enter fr a chance t win TELUS WISE ftprint is a prgram that engages Canadian yuth (ages 7 thrugh 14) in learning hw t keep their digital ftprint
More informationTubing Group Guide. Wilmot Mountain Tubing, a Vail Resorts Company Fox River Rd. Twin Lakes, WI 53181
Tubing Grup Guide Wilmt Muntain Tubing, a Vail Resrts Cmpany 12301 Fx River Rd. Twin Lakes, WI 53181 Phne: 262-862-2301 ext 110 www.wilmtmuntain.cm WilmtMtnGrups@vailresrts.cm www.facebk.cm/wilmtmtn Welcme
More informationPLATTSVILLE FIGURE SKATING CLUB REGISTRATION FORM OCTOBER 2015 TO MARCH 2016
PLATTSVILLE FIGURE SKATING CLUB REGISTRATION FORM OCTOBER 2015 TO MARCH 2016 Full name: Street address: City: Pstal Cde: Birth date: (M/D/Y) Gender: F M Phne number: Cell phne number: Email address: Skate
More informationGRANBEAST LITTLE LEAGUE BASEBALL / SOFTBALL COACHES HANDBOOK 2018
GRANBEAST LITTLE LEAGUE BASEBALL / SOFTBALL COACHES HANDBOOK 2018 First and fremst, thank yu fr vlunteering and giving yur time t the kids f East Granby/Granby Little League This dcument will hpefully
More informationVisit Leader Emergency Action Card
Visit Leader Emergency Actin Card If an Establishment decides t adpt this card, it shuld be carried by all staff accmpanying a visit. It is recmmended that this is printed, laminated, and als placed in
More informationW R E S T L I N G B C B r i t i s h C o l u m b i a W r e s t l i n g A s s o c i a t i o n
Athlete/Cach Nminatin Criteria 1 W R E S T L I N G B C B r i t i s h C l u m b i a W r e s t l i n g A s s c i a t i n Canadian Sprt Institute Pacific and BC Wrestling Athlete and Cach Nminatin Criteria
More informationBYHA REGISTRATION INFORMATION
BYHA REGISTRATION INFORMATION BETHLEHEM YOUTH HOCKEY PO BOX 345 DELMAR, NEW YORK 12054 www.bethlehemhckey.rg Prgram Descriptins (Nte: depending n registratin numbers, teams may be added r remved as needed
More informationUsers Requirements Statement
Mnday, March 29, 2004 http://www.prjectdevelper.cm Cntents Agreement s Purpse... 2 Applicatin s Descriptin... 2 Applicatin s Input/Output Summary... 4 Business Rules... 8 Applicatin Develpment Cmpletin
More informationCanadian Sport Institute Pacific and Badminton BC Athlete and Coach Nomination Criteria
Athlete/Cach Nminatin Criteria 1 Canadian Sprt Institute Pacific and Badmintn BC Athlete and Cach Nminatin Criteria Criteria Apprved March 28 th, 2018 CSI Pacific Representative L. Jennerich Signature
More informationATHLETICS AUSTRALIA SELECTION POLICY WORLD CROSS COUNTRY CHAMPIONSHIPS AARHUS, DENMARK 30 MARCH 2019
Athletic Australia Selectin Plicy 2019 Wrld Crss Cuntry Champinships ATHLETICS AUSTRALIA SELECTION POLICY WORLD CROSS COUNTRY CHAMPIONSHIPS AARHUS, DENMARK 30 MARCH 2019 This dcument sets ut the basis
More informationWAIS Swimming Scholarship Selection Guidelines, Criteria and Process
WAIS Swimming Schlarship Selectin Guidelines, Criteria and Prcess Apprved by: Executive Directr Effective frm: January 19 2016 Next review date: January 2017 Last Date f Edit: January 2016 1. Athlete Selectin
More informationWCSC Walnut Tournament 2018
Turnament Headquarters Heather Farms 1 (HF1) will serve as the Primary Turnament Headquarters. Turnament standings and any ther annuncements pertinent t the turnament will be psted at an infrmatin area
More informationCheck the medication record to see what medicine is due at that time;
Appendix 1: Administratin f Medicatin Guidance Checklist: If yu wish, yu may print ut this Appendix, Click here dwnlad a PDF versin, then print it ff. All medicines must be administered strictly in accrdance
More informationJOONDALUP KINROSS JUNIOR FOOTBALL CLUB INCORPORATED JETS. Registration & Player Placement Policy
JOONDALUP KINROSS JUNIOR FOOTBALL CLUB INCORPORATED JETS Registratin & Player Placement Plicy Page 1 f 8 Nvember 2011 Please read the fllwing t ensure bth yu and/r yur child get the mst ut f yur invlvement
More informationSelection Policy for Badminton Australia Support Structure (BASS) and National Squad.
Selectin Plicy fr Badmintn Australia Supprt Structure (BASS) and Natinal Squad. Prgram Outline The main purpse f the Badmintn Australia s (BA) High Perfrmance (HP) prgram is t achieve internatinal success.
More informationBadminton New Zealand Sanctioned Events Information and Time-lines
Badmintn New Zealand Sanctined Events Infrmatin and Time-lines Updated January 2017 A Badmintn New Zealand (BNZ) sanctined event means that the event is part f the BNZ Player Pints system (with the exceptin
More informationSPONSORSHIP PACKET. Contact Information: Heidi Long, American Cancer Society Work: (312)
SPONSORSHIP PACKET Cntact Infrmatin: Heidi Lng, American Cancer Sciety Wrk: (312) 960-2304 Email: Heidi.Lng@cancer.rg WHAT DOES YOUR INVESTMENT DO? Abut the American Cancer Sciety Windy City Glf Open
More informationDistrict 6 and Unit 190 (D4) STaC - Conditions of Contest & Reporting Instructions Fall 2018
District 6 and Unit 190 (D4) STaC - Cnditins f Cntest & Reprting Instructins Fall 2018 Key Infrmatin fr Club Owners: Please read and pst near the scring cmputer fr the directrs use during STaC week. Sanctin
More informationCypress Creek Cheerleading Cheerleader Tryout Information Packet
. Cypress Creek Cheerleading 2018-2019 Cheerleader Tryut Infrmatin Packet Dear Cheerleader Applicant, Please read thrugh the attached material. If yu feel yu meet the requirements fr tryut eligibility,
More information2019 Rulebook. Individual Male Individual Female Team (2 Male, 2 Female)
2019 Rulebk The Brazil CrssFit Champinship (BCC) is an annual, sanctined CrssFit cmpetitin. In 2019, the BBC will take place n May 17-19 in Sã Paul and hst the fllwing divisins: Individual Male Individual
More informationMore than one measurement shall be obtained at the 2018 MCAC if either of the following conditions exists:
2019 IFCS Wrld Team Selectin Rules Cmpetitrs wishing t qualify fr the 2019 IFCS Wrld Team are required t attend the Masters Challenge Agility Cup (MCAC) being held August 23-26, 2018, in Franklin, Tennessee.
More informationNebraska State Motocross Series
Nebraska State Mtcrss Series Rules f Cmpetitin These rules are t be used fr all events held in cnjunctin with the Nebraska State Mtcrss Series (NSMS). The Nebraska State Mtcrss Series is nt AMA sanctined
More informationInaugural Fort Christmas Bluegrass & Backyard BBQ Festival
Inaugural Frt Christmas Bluegrass & Backyard BBQ Festival March 24, 2018 T qualify as a Backyard team, the team culd nt have wn a cash prize in a previus BBQ cntest r been cmpensated as a prfessinal BBQ
More informationLivermore Harley Owners Group RIDING WITH LIVERMORE HOG
Livermre Harley Owners Grup RIDING WITH LIVERMORE HOG 2010 Riding with Livermre HOG Table f Cntents Page 1 Welcme Page 2 Ride Planning Page 2 Rad Captains Page 2 Grup Ride Basics Page 3 Grup Riding Prcedures
More informationInternational Military Sports Council. Sports Committee CYCLING. Rules and Regulations
Internatinal Military Sprts Cuncil Sprts Cmmittee CYCLING Rules and Regulatins English Editin 2016 1 Cntent Chapter I: General... 4 1.1 UCI... 4 1.2 Organizing Cuntry and Organizatin... 4 1.3 The Champinships...
More informationMYSL Cup Overview. The Michigan Youth Soccer League (MYSL) will administer and govern the MYSL Cup.
MYSL Cup Overview MYSL CUP Overview 2018 The MYSL Cup is a tw-year intra-league cmpetitin that begins each fall fr MYSL - registered U11 teams and cncludes fr thse teams in their U12 Spring seasn. The
More informationWestern Australian Figure Skating Club Championships
WAFSC Club Champinships Western Australian Figure Skating Club Champinships EVENT STATUS: Club Event Event Date 28 th Octber 2017 4:30 7:15pm 29 th Octber 2017 4pm TBC Date Clse f Entries 29 th September
More informationGROVE SCHOOL BIRMINGHAM CITY COUNCIL E-SAFETY POLICY FOR SCHOOLS
GROVE SCHOOL BIRMINGHAM CITY COUNCIL E-SAFETY POLICY FOR SCHOOLS 1. Intrductin 1.1 The gverning bdy f Grve Schl has adpted this plicy t help the schl meet its respnsibilities fr safeguarding and educating
More informationUSTA Northern California Junior Team Tennis Section Championship Rules (Updated as of 8/1/16)
USTA Nrthern Califrnia Junir Team Tennis Sectin Champinship Rules (Updated as f 8/1/16) All Stats & Standings will be n TennisLink: http://tennislink.usta.cm/teamtennis/main/hme.aspx Turnament Directr:
More informationLocation Consider areas in your community to focus attention on pedestrian safety. Example locations include:
Crsswalk event verview (Saint Paul) A crsswalk event ccurs when an individual r grup f individuals prmte pedestrian safety by demnstrating the prper use f a crsswalk. During the event, a grup f cmmunity
More informationCONTACT INFORMATION FORM
Phne 425-644-7999 Address: 2005 152 nd Ave NE Redmnd, WA 98052 wahyperbarics@gmail.cm Client Name Date f Birth Diagnsis Patient s Address CONTACT INFORMATION FORM Hme phne Mbile Phne Wrk Phne E-mail address
More informationSan Diego-Imperial Swimming 2017 Winter Age Group Championship December 16 18, 2017
SANCTION: This meet is sanctined by USA Swimming and issued by San Dieg- Imperial Swimming #SI-17-52. In granting this sanctin it is understd and agreed that USA Swimming shall be free frm any liabilities
More informationExercise 2: Reviewing the Workplace Inspection Checklist (30 min) p
Exercise 2: Reviewing the Wrkplace Inspectin Checklist (30 min) p. 19-20 Part One: Behaviurs vs. Cnditins (15 min) Wrking individually: Think f 3 r 4 incidents that have ccurred r have the ptential t ccur
More informationCanadian Sport Institute Pacific and Cycling BC Athlete and Coach Nomination Criteria
Athlete/Cach Nminatin Criteria 1 Canadian Sprt Institute Pacific and Cycling BC Athlete and Cach Nminatin Criteria CSI Pacific Representative Criteria Apprved January 2018: Cycling BC Representative, Tara
More informationDear Potential Sponsor,
Dear Ptential Spnsr, On behalf f, we wuld like t extend this pprtunity t yu and yur rganizatin t becme a partner with us. ABOUT USATF We are the Natinal Gverning Bdy fr track & field, lng distance running
More informationSydney Figure Skating Club Golden Anniversary 2018 Hollins Trophy, Co-Operative Cup Carr s Cup and Dance Cup
EVENT STATUS: ISA Benchmark Event excluding Dance Event Date Friday 8 th June, Saturday 9 th June, Sunday 10 th June and Mnday 11 th June 2018 Date Clse f Entries Friday 11 th May 2018, 5:00pm Date Time
More informationHealth and Safety Policy for Groups Policy
Wdcraft Flk Plicy Health & Safety fr Grups Plicy Revised by: Debs McCahn & Sarah McGvern February 2013 Health and Safety Plicy fr Grups Plicy Last updated: February 2013 Revised by: Debs McCahn (Membership
More informationREEDSBURG YOUTH FOOTBALL, INC. Program Rules & Regulations
REEDSBURG YOUTH FOOTBALL, INC. Prgram Rules & Regulatins Reedsburg Yuth Ftball (RYF) Prgram is designed t serve a wide variety f yung athletes. Many factrs have been cnsidered in creating ur rules and
More informationCanadian Sport Institute Pacific and Cycling BC Athlete and Coach Nomination Criteria
Athlete/Cach Nminatin Criteria 1 Canadian Sprt Institute Pacific and Cycling BC Athlete and Cach Nminatin Criteria CSI Pacific Representative Criteria Apprved December 5, 2018: Cycling BC Representative,
More informationRep Tryout Procedure Guidelines. Supplement to Policy 7 - Rep Hockey. Date Revised: July Version 1.3
Supplement t Plicy 7 - Rep Hckey Date Revised: July 2017 Versin 1.3 1 Table f Cntents Table f Cntents 1 Rep Tryut Prcedure Guidelines 2 Intrductin: 2 Rep Tryut Objectives: 2 Purpse f Player Evaluatin and
More informationMillbrook High School Cheerleading
Millbrk High Schl Cheerleading Welcme! We are lking frward t anther great year f Millbrk Cheerleading! Wildcat Cheerleaders are expected t shw the highest athleticism, sprtsmanship, mral cde f ethics,
More informationINFORMATION SHEET: OUT OF HOURS WORKING RISK ASSESSMENT AND CONTROLS
INFORMATION SHEET: OUT OF HOURS WORKING RISK ASSESSMENT AND CONTROLS This Infrmatin Sheet prvides guidance n what t cnsider when undertaking an Out f Hurs Wrking risk assessment and deciding the cntrls
More informationGo Ride A Wave - Employment Information Sheet (V13)
G Ride A Wave - Emplyment Infrmatin Sheet (V13) Welcme t G Ride A Wave! Established in 1987, G Ride A Wave (GRAW) is an industry leader in utdr adventure educatin and recreatin. The cmpany perates in tw
More informationGonzales Come and Take It Celebration Parade Entry Packet
Dear Parade Participants: Gnzales Cme and Take It Celebratin Parade Entry Packet Gnzales, the "Cradle f Texas Independence", will celebrate the firing f the first sht fr Texas Independence this year n
More informationFirst Aid Policy. North Halifax Grammar School. Approved by: Principal. Date approved: November Next review: Autumn Term 2020.
Nrth Halifax Grammar Schl First Aid Plicy Apprved by: Principal Date apprved: Nvember 2017 Next review: Autumn Term 2020 Plicy wner: Schl Welfare Officer Created April 2014 General The Academy is required
More informationSETTING UP A CLUB. Westmorland County Football Association Limited. Contacts. Chief Executive Peter Ducksbury
Westmrland Cunty Ftball Assciatin Limited SETTING UP A CLUB Cntacts Chief Executive Peter Ducksbury Ftball Develpment Officer James Pattisn Assistant Ftball Develpment Officer/ Cmmunity Cach Graeme Blair
More informationCAROUSEL DANCE COMPANY 2014/2015 INFORMATION PACKAGE
CAROUSEL DANCE COMPANY 2014/2015 INFORMATION PACKAGE DANCE COMPANY 2014/2015 Cmpany Directrs: Heidi Churchill & Laura Prada Turing Cmpany Directr: Crystalle Kruis Dance Cmpany is an exciting pprtunity
More information