Observation Request/Payment RI Middle School Showdown

Observation Request and Payment for RI Middle School Showdown Championship -2/11/2023
This form is to be used by a USA Swimming athlete member wishing to have their race observed by a USA Official and entered into the SWIMS database.

MEET: RI Middle School Showdown Championship

Please complete this form and submit it with a $5.00 payment per event by February 10th at 5pm.
NEW SWIMS ID NUMBER (14 Characters)*
First Name*
Middle Name or initial (if none type*)*
Last Name*
Date of Birth*

MonthDayYear
Date
USA SWIMMING CLUB NAME*
Email*
example@example.com
Cell Phone Number*
Please enter a valid phone number.
Swimmers are only allowed 2 individual events and two relay lead off times (or 1 individual event and three relay leadoffs). Please indicate the events for which the swimmer is entered and wants observed.
Check off the events you would like observed:

200 Medley Relay (lead off)200 yd Freestyle100 yd Ind Medley50 yd Freestyle200 yd Backstroke100 yd Breaststroke50 yd Butterfly100 yd Freestyle50 yd Backstroke50 yd Breaststroke200 yd Freestyle Relay (lead off)
RELAY: If entire relay is made up of USA Swimmers from the same team and you want the relay entered list the relay name and all four names in order of swim:
My Products
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Events to be observed
$5.00 Quantity

Total

$0.00
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Observation Request and Payment for RI Middle School Showdown Championship -2/11/2023