NAME | AGE | (As of March 31, 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 # | #(________) |
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.
Swimmer’s Signature: | Date: | ||
Parent’s Signature: |
Mail completed zone application to: | James Garner
12904 Meadow View Drive ; Gaithersburg, MD 20878-2168
Important: No FAX applications accepted. Direct your inquiries regarding team participation to Breanne Smith at 703-790-0760 or Breanne's email. IMPORTANT: A list of applications received will be posted promptly upon receipt. Therefore, please wait at least one week before inquiring about the status of any application submitted. |
REMINDER: Deadline for all applications is MONDAY February 28, 2005 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)
If so,
please also complete this additional form. (NOW POSTED) You may
update the specific events you want to swim until March 23.
Special Note: Late applications will be accepted from 14/U swimmers until March 13 and from 15-18 year old swimmers until March 6. Late applications must be accompanied by a $10 late payment fee payable to Potomac Valley Swimming.