Gender Self-Identity Verification Request

Gender Self-Identity Verification Request
This form is based on USA Swimming Athlete Gender Inclusion, Competitive Equity and Eligibility Self-Identity Verification Request.
Individual Completing this Request Form:
Relationship to athlete (select):*

SelfParent/Legal GuardianCoachOther
If not the athlete or athlete’s parent/legal guardian, please provide the following: Is the athlete’s parent/legal guardian aware of this request?*

YesNo
Is the athlete’s club/coach aware of this request?*

YesNo
Are there concerns with GRAL contacting the athlete’s club about this request?*

YesNo
Name*

First NameLast Name
Email*
example@example.com
Phone Number*
Please enter a valid phone number.
GRAL Athlete Information:
Which of the following applies to the athlete?*

The athlete is a current member of a GRAL team who wishes to change the competition category in which they participate.The athlete is a former member of a GRAL team who wishes to join a GRAL team as a member and register in a competition category different than the biological gender assigned to the athlete at birth.The athlete has never been a member of a GRAL team who wishes to join a GRAL team as a member and register in a competition category different than the biological gender assigned to the athlete at birth.
Is the athlete requesting a name change with GRAL?*

YesNo
Athlete’s original competition category:*

MaleFemale
Athlete’s requested competition category:*

MaleFemale
Original Name under which Athlete has Competed*

First NameLast Name
Requested Name for Athlete*

First NameLast Name
Preferred name (nickname)
Athlete's Club*
Has the athlete previously requested a competition category change request?*

YesNo
By submitting this Self-Identity Verification Request the athlete, and/or the athlete’s parent/legal guardian, as applicable, represents and agrees that:
(a) All information submitted in connection with the Request is accurate and complete to the best of their knowledge and that no relevant information has been intentionally withheld.
(b) The athlete will fully cooperate with and provide any additional information requested by GRAL.
(c) Neither GRAL, nor any GRAL contractors, directors, officers, agents, representatives, or other persons involved in the administration of this request shall be liable in any way in relation to acts done or omitted to be done in good faith in connection with the administration of the applicable Policy
Type your name to consent to the above.*
Should be Empty:

Gender Self-Identity Verification Request

Individual Completing this Request Form:

GRAL Athlete Information: