Meet information - USA Swimming
Meet information - USA Swimming
Meet information - USA Swimming
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TEAM NAME:<br />
2013 <strong>USA</strong> SWIMMING/SPEEDO CHAMPIONS SERIES<br />
WESTERN REGION SECTION CHAMPIONSHIP<br />
Hosted by Mt Hood Aquatics<br />
Mt. Hood Aquatic Center<br />
July 16-20, 2013<br />
E-MAIL ENTRY FORM<br />
CLUB CODE:<br />
COACH NAME:_ PHONE #:<br />
COACH’S <strong>USA</strong> ID#:<br />
HOME ADDRESS:<br />
EMAIL ADDRESS:<br />
City State Zip<br />
E-MAIL QUALIFICATION PERIOD – July 9 - July 14, 2013<br />
E-MAIL DEADLINE – 11:59 p.m., Sunday, July 14, 2013 (PDT)<br />
LATE ENTRY DEADLINE – 12:00 noon, Monday July 15, 2013 (PDT)<br />
NEW QUALIFYING SWIMS: Swims achieving the qualifying time standards for the first time from<br />
Tuesday, July 9, 2013 through Sunday, July 14, 2013. These e-mail entries must be received no later than<br />
11:59 p.m. (PDT) on Sunday July 14, 2013, and may not be used to improve the seed time of a previously<br />
submitted entry.<br />
LATE ENTRIES: Swims achieving the qualifying time standards that were not entered previous to the<br />
OME deadline and will be charged twiee the entry fees. These e-mail entries must be received no later than<br />
12:00 noon (PDT) on Monday, July 15, 2013, and may not be used to improve the seed time of a previously<br />
submitted entry.<br />
We have entered the following events on this e-mail entry form:<br />
NEW QUALIFIERS<br />
LATE ENTRIES:<br />
Women: Individual Events __________ x $8.00 = _____________ Women: Individual Events _________ x $16.00 = __________<br />
Men: Individual Events _____________x $8.00 = _____________ Men: Individual Events ____________x $16.00 = ___________<br />
Relays: # of Relays ________________x $20.00=_____________ Relays: # of Relays _______________x $40.00=____________<br />
Surcharge: # of Swimmers __________x $35.00 = ____________ Surcharge: # of Swimmers _________x $35.00 = ___________<br />
Total Entry Fee: $ __________________ Total Entry Fee: $_________________<br />
Emailed entries must be paid at the Clerk of Course.<br />
The undersigned coach or team representative of all swimmers listed on this entry form hereby certifies that all<br />
times stated on this entry form are true and correct.<br />
Coaches Signature:_______________________________________________________________________________<br />
Swimmer Information<br />
Print Name ______________________________________________________________ Age __________________<br />
Team Name____________________________________________________________________________________<br />
Female __________ Male __________ Registration # __________________________________________________<br />
Swimmer previously entered in meet?<br />
Yes ____________ No ______________<br />
Event # _________ Event _______________________ Time ____________________ Date Achieved ____________<br />
Event # _________ Event _______________________ Time ____________________ Date Achieved ____________<br />
Event # _________ Event _______________________ Time ____________________ Date Achieved ____________<br />
Event # _________ Event _______________________ Time ____________________ Date Achieved ____________<br />
Event # _________ Event _______________________ Time ____________________ Date Achieved ____________<br />
If 6 th event must be dropped, please drop Event #_______________<br />
(Duplicate this form as Necessary)<br />
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