GRAL Special Needs Request Form

GRAL Special Needs Request Form

We prefer for the coach to fill out this form.
Year*
Club Name*
Swimmer Name*
Swimmer Age*
Swimmer Gender*

FemaleMale
Please explain the exemption request and rationale.*
Is the Swimmer currently a member in good standing of your team?*

YesNo
Has this swimmer had the same exemption in the past?*

YesNo, this is the first time a request has been madeNo, the swimmer had a different accommodation
Name of Person filling out this form*

First NameLast Name
Role with club*
E-mail*
Phone Number*

Area CodePhone Number
Anything else you want to tell us?
Should be Empty: