Swimming Australia Individual Clearance Request Form

1
I am requesting Clearance for:* This field is required.(Enter the full legal name of the swimmer)
First Name
Last Name
2
Born on:* This field is required.
Date
Day
Month
Year
3
The swimmer is a member of the below State Swimming Organisation:* This field is required.
ACT
NSW
NT
QLD
SA
VIC
WA
TAS
4
What level of Australian membership does this swimmer hold? This can be viewed in the swimmer's Swim Central profile under Memberships* This field is required.
5
The swimmers membership expires on:* This field is required.If their membership expires before the clearance request dates, this clearance may not be approved.
Date
Day
Month
Year
6
The country/ies you plan to visit are:* This field is required.
7
Please provide the name and date of the international competition/s you will attend during your visit:* This field is required.
Huge
Large
Normal
Small
Ok
Ok
8
This clearance request will be valid between the below dates:* This field is required.
9
Your email* This field is required.We will use this email to send confirmation of this request and a copy of the clearance letter, if approved by Swimming Australia
example@example.com
10
Terms and Conditions* This field is required.
Should be Empty: