APPLICATION DEADLINE TUESDAY JULY 19, 2005

PVS 2005 LONG COURSE ZONE TEAM APPLICATION

NAME AGE 
(As of August 10, 2005)
 
ADDRESS SEX: M   F 
  CLUB  
PHONE #(________)
E-MAIL ADDRESS 
Athletes USA Swimming Registration #  
NOTE: Application will not be accpeted without correct USA swimming registration number.
COACH   COACH’S PHONE # #(________)

ATHLETES MUST PROVIDE TIMES TO ZONE COORDINATOR AND WEBMASTER
FROM NON PVS MEETS THAT ARE NOT IN THE PVS TM4.0 DATA BASE
EVENT, TIME, NAME OF MEET, AND LOCATION IS REQUIRED
MEET MUST BE SANCTIONED OR SWIM MUST HAVE BEEN PROPERLY OBSERVED.

SELECTION OF RELAYS Relay teams will be selected by the Zone Team coaching staff. The position in a relay and/or the strokes swum in medleys will also be determined solely by the coaching staff.

In submitting this application, we understand that a swimmer selected for this team will be representing PVS, and as such will follow all guidelines and codes of conduct established by Potomac Valley Swimming.

VERY IMPORTANT: We further acknowledge that we are aware that PVS will travel to and from Zones as a team this year. This means we undetstand we must travel to the meet with the team -- leaving Tuesday mornng August 9 and returning Sunday afternoon -- August 14. We will stay at the team hotel, have meals with the team, and participate in other team activities unless officially excused by the Head Coach or Team Manager.

Swimmer’s Signature:   Date:  
Parent’s
Signature: 		 
Mail completed zone application to: Mark Faherty   9730 Blake Lane ;   Fairfax, VA 22031    Applications may be FAXed to xxx-xxx-xxxx
You may direct your inquiries regarding team participation to Mark Faherty, Head Coach at fahertyswim@yahoo.com; Breanne Smith, Assistant Head Coach at or Paris Jacobs, Team Manager at xxx-xxx-xxxx Breanne's email.
IMPORTANT: A final list of applications received will be to the PVS website by Wednesday evening, July 20. Therefore, please wait until this list has been posted before inquiring about the status of any application submitted.

REMINDER: Deadline for all applications is TUESDAY JULY 19, 2005 at 4PM Note: If using Fed Express, UPS, etc., sign the waiver allowing for the service to leave your application without requiring a signature.

Swimmers with a Disability. Are you applying to be a member of the PVS Eastern Zone Team under provisions in the meet announcement pertaining to swimmers with a disability. (see pages 4-5)
Yes ________ No _________

If so, please also complete this additional form. (NOW POSTED) You may update the specific events you want to swim until July 26.

Late applications for this meet will be accepted thru the conclusion of 10/U session Sunday July 24. They must be submitted to the zone table at the Age Group Championship Meet. A late application fee of $15 payable to PVS will be charged. The initial deposit of $250 will also be due at this time.