APPLICATION FOR SAN DIEGO-IMPERIAL LMSC (SI) RECORD

APPLICATION FOR SAN DIEGO-IMPERIAL LMSC (SI) RECORD



1. Course (check one) _________SCY    _________SCM    _________LCM

2. Distance ____________________   3. Stroke_______________________________
            50-100-200-400-500              Free, Back, Breast, Fly, IM,
            800-1000-1500-1650              Free Relay, Medley Relay 

4. Official Time _____:_____._____
                   min:  sec.hundredths

5. Primary timing for this performance (check one below)
   _____Electronic Timing  _____ Semi-automatic (buttons)  _____ Stopwatches

6. For Individual Events:  Age Group __________

   ____________________________  ______  ____________________  ___ ______________
   Last Name, First Name         Gender  Birthdate (mm/dd/yr)  Age USMS number

7. For Relay Events: Club Name ____________________________ Relay Age Group _____
   (List names in order of competing)
   ____________________________  ______  ____________________  ___ ______________
   Last Name, First Name         Gender  Birthdate (mm/dd/yr)  Age USMS number
   ____________________________  ______  ____________________  ___ ______________
   Last Name, First Name         Gender  Birthdate (mm/dd/yr)  Age USMS number
   ____________________________  ______  ____________________  ___ ______________
   Last Name, First Name         Gender  Birthdate (mm/dd/yr)  Age USMS number
   ____________________________  ______  ____________________  ___ ______________
   Last Name, First Name         Gender  Birthdate (mm/dd/yr)  Age USMS number

8. Meet Name & Location _____________________________________________________

   Sanction # _________________ Last Day of Meet __________________ LMSC ________

9. Select one: _______ USMS Sanctioned  _______ USMS Recognized ______ USA-S Meet

10.If the meet is out-of-district and time is not fast enough to make the National
   Top Ten list, attach official meet results or list web address of results.
   Official results attached __________ (must show course length and meet date)
   Official results located at web address _______________________________________

Instructions: Whenever an SI swimmer or relay swims an official time faster than 
the listed SI LMSC record for short course yards (25 yd course), short course meters
(25 meters), or long course meters (50 meters), please notify the SI Records Chair
Barbara Dunbar using this form. 

Send completed form by E-mail to SISecretary(AT)usms(DOT)org or
by mail to 5666 La Jolla Blvd #156, La Jolla, CA 92037.  All swims must be done in 
pools certified for length.  Updated pool length certification forms must be on file
or accompany this form.  Additional verification of official times may be required 
such as electronic split sheets.
2004 SI LMSC Records Form