2025-2026 LSC Club Information Form

2025-2026 NEW ENGLAND SWIMMING

LSC CLUB INFORMATION FORM

This form is to be submitted by all new and existing clubs to provide the LSC office of current club information, such as club contact person, website address and House of Delegates designations.

Club Name:*

Club Code:*

List the City (Cities) and State for all your practice locations*

Have you already renewed/registered your club in SWIMS 3.0 for 2025?*

YesNo

Website Information

Find your club on the newswim.com website listing and then enter the information you would like displayed on the CLUBS section of our website if it is different.

Club Website Address

Team Contact Name to be Displayed on the Website

First NameLast Name

Team Contact Email for Website

example@example.com

Team Contact Phone for Website (if desired)

Area CodePhone Number

Head Coach Name to be Displayed on the Website (if different from Club Contact)

First NameLast Name

Head Coach Email for Website

example@example.com

Head Coach Phone for Website

Area CodePhone Number

Please let us know if you have a club excellence level (Bronze, Silver, Gold) and/or Safe Sport Recognized. We will post the appropriate symbol for your achievement(s) on the website.

For Our Contact Purposes

CLUB REGISTRAR NAME:

E-mail

Phone Number

Area CodePhone Number

Club Representatives for the House of Delegates

YOUR CLUB HOD Delegate: Please name the person who will represent your club at the HOD meeting and receive the vote that is allotted to your team (this can be changed before the meeting if necessary)*

E-mail*

Alternate HOD Delegate: Please name the person who will represent your club at the HOD meeting if the named delegate cannot attend. This person will receive the vote that is allotted to your team (this can be changed before the meeting if necessary)*

E-mail*

At-Large Athlete Rep for the House of Delegates

Each club is entitled to name an athlete that is at least age 16 or a sophomore in High School and in good standing to be elected as an At-Large ATHLETE DELEGATE for the HOD meetings. The athlete delegates will be voted in at a Board of Director’s meeting within 30 days of the HOD meeting and will have voting privileges at the NE House of Delegates meeting.

This athlete can be the same person as your Athlete Rep but must meet the above criteria. If your club does not have an athlete that is old enough to serve in this role please leave it blank.

Name of At-Large Athlete Rep for the HOD: (make sure they are aware they are being selected) If you do not have an athlete rep, please write none.*

Athlete HOD Rep E-mail*

Name an alternate HOD Athlete Delegate (must be at least age 16 or or sophomore in HS)

Alternate's email

example@example.com

Athlete Representative

Please list an athlete that is willing to represent your team. This athlete must be 13 years or older and will act as the liaison between the athletes on the team and the Athlete Representatives on the New England Board. The rep's info will NOT be posted anywhere on our website, but will be used by the NES Athlete Reps to disseminate information to your club’s swimmers, and to gather opinions about certain policies and discussions.

Name of Athlete Rep:(make sure they are aware they are being selected) If you do not have one please write none.*

Athlete Rep E-mail*

Safe Sport Coordinator

Every club is required to have a Safe Sport Coordinator. This person will work with the LSC Safe Sport Chair to plan and schedule required training sessions for coaches, parents, and athletes. The Safe Sport Coordinator should not be the Head Coach. It can be a parent who is willing to be trained, an Official, or an assistant coach who has the time and interest to devote to the work. The Safe Sport Coordinator must be registered as a non-athlete.

SAFE SPORT COORDINATOR NAME:

E-mail

Phone #

Has your club already completed the Safe Sport Recognition Program (SSRP)?

YesNo

If no, when do you plan to begin or renew it? What obstacles are preventing your team from beginning the program?

Name of person completing this form:

Email of person to receive receipt

example@example.com

Signature