Unit Swim Classification Record - Michigan Crossroads Council printable pdf download

Unit Swim Classification Record - Michigan Crossroads Council

Unit Swim Classification Record

This is the individual’s swim classification as of this date. Any change in status after this date

(i.e., nonswimmer to beginner or beginner to swimmer) would require a reclassification test

performed by an approved test administrator. Changes and corrections to the following chart

should be initialed and dated by the test administrator.

SPECIAL NOTE: When swim tests are conducted away from camp, the camp aquatics director

retains the right to review or retest any or all participants to ensure that standards have been

maintained.

Unit Number _________________

Date of Swim Test _______________

Full Name (Print)

Swim Classification

Medical

Recheck

Nonswimmer

Beginner

Swimmer

(Draw lines through blank spaces.)

NAME OF PERSON CONDUCTING THE TEST:

(Person must be approved by the MCC Aquatics Chair)

_______________________________________

Print Name

Signature

_______________________________________

Qualification

Council/Agency (Red Cross, YMCA, etc.)

UNIT LEADER:

______________________________________

____________________________________

Print Name

Signature

430-122

(OVER)

Revised: March 2009

Please send a copy of the completed form to: MCC Aquatics Chair, 137 S Marketplace Blvd, Lansing MI 48917

Unit Swim Classification Record - Michigan Crossroads Council