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M1 Swimming Club - Record Application
Please submit this to apply for recognition of a club record.
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* Indicates required question
Email
*
Your email
Full name of person submitting this application
*
Your answer
First name of swimmer
*
Your answer
Last name of swimmer
*
Your answer
Swimmer's gender
*
Female
Male
Swimmer's date of birth
*
MM
/
DD
/
YYYY
Swimmer's age on day record was achieved
*
Your answer
Date when record was achieved
*
MM
/
DD
/
YYYY
Name of swim meet where record was achieved
*
Your answer
Type of record
*
Long course
Short course
Event record was achieved in (distance and stroke)
eg. 200 Free
*
Your answer
Time swum
*
Your answer
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