2023 TRANSFER FORM

USA SWIMMING/NEW ENGLAND SWIMMING

2022-2023 ATHLETE TRANSFER REQUEST FORM

Fill out this entire form and hit the submit button at the bottom. There is a $10.00 transfer fee per swimmer that you can pay by credit card or check.

You may transfer up to 3 swimmers per family on this form.

How many swimmers in family will you transfer using this form?

On what date did you start with the new team?*

1st SWIMMER LAST NAME*

1st SWIMMER FIRST NAME*

1st SWIMMER FULL MIDDLE NAME (If none, write none)*

1st Swimmer gender*

1st swimmer DATE OF BIRTH*

MonthDayYear

2nd SWIMMER LAST NAME

2nd SWIMMER FIRST NAME

2nd SWIMMER FULL MIDDLE NAME (If none, write none)

2nd Swimmer gender

2nd Swimmer DATE OF BIRTH

MonthDayYear

3rd SWIMMER'S LAST NAME

3rd SWIMMER'S FIRST NAME

3rd SWIMMER'S FULL MIDDLE NAME (If none, write none)

3rd Swimmer Gender

3rd Swimmer DATE OF BIRTH

MonthDayYear

Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry

Phone Number*

Area CodePhone Number

PREVIOUS CLUB/TEAM INITIALS*

PREVIOUS STATE/COUNTRY:*

NEW CLUB NAME that you are TRANSFERRING TO:*

Contact email of the new team you are transferring to:*

If you are a member of another FINA, list the date of the last competition swim in the other FINA.

1. PER NE POLICY, If you have NOT been a member in New England Swimming previously, upload a copy of proof of age, such as a birth cert copy or passport. You can black out any information other than swimmer name and DOB if desired.

Submission of this form will confirm that the above information is correct. I understand that the above athlete will remain Unattached for 120 consecutive days from the date of last open sanctioned competition in accordance with USA Swimming Rules and Regulations 203.3.

The athlete’s former club will be notified that a transfer has occurred. It is the responsibility of the athlete’s former club to notify the LSC Registrar if the club has obtained a court judgment which would cause the swimmer to be unattached pursuant to Article 203.6.

Article 203.6 If a member club of an LSC has secured a court judgment against an athlete member (or his/her parents or custodians) for non-payment of club membership dues and fees which entitle the athlete to compete attached to the club that athlete shall be ineligible to represent any USA Swimming member club until the judgment is paid.

Signature of athlete, parent or guardian*

Email address*

example@example.com

Payment Options*

Credit Card thru Pay PalBy check (this will delay processing)Club is paying

The fee is $10/swimmer. Please select the quanity in the box below to adjust your total payment to reflect the correct number of transfers in this form.

If paying by check please make the check out to and and send to:

New England Swimming
1241 Highland Ave. Rear
Needham, MA 02492

Your transfer will not be processed until payment is received.

Use the mouse or finger (on touchscreen) to sign:

Select transfer AND QUANTITY

Transfer$10.00

Be sure to select the correct quantity below

Quantity

Subtotal $0.00Shipping $0.00Total $0.00

loading smart payment buttons...

New England Swimming, INC
1241 Highland Ave. REAR, Needham, MA 02492
781-449-0270 (p) 781-449-7903 (f) registrarnes@gmail.com