MSSA Open Water Swim Series Sanction Request Form

MSSA Open Water Swim Series Summary Report Form

(To be Completed by Event Coordinator)
Masters Club Name
Event Name
Date of Event

MonthDayYear
Date
Venue
Event Coordinator's Name
Event Coordinator's Contact Number
Event Coordinator Email
example@example.com

2. Any Disqualifications

YesNo
If Yes, please List Swimmer and Reason
3. Incident / Injury Reports (This covers injuries that occurred during the swim and any incidents that could have resulted in an injury)
If an injury occurred was an Injury Report Form completed

YesNo
If Yes, please attach a copy of the Injury Report Form

Browse Files

Cancelof

If an Incident occurred was an Incident Report Form completed

YesNo
If Yes, please attach a copy of the Incident Report Form

Browse Files

Cancelof
Recommendations for Future Events (This covers problems and changes that need to be looked at by Organisers, Technical or Branch)

Officials in Attendance

	Name
Event Coordinator
Referee
Clerk of Course
Registrar
Starter
Chief Timekeeper
Timekeeper 1
Timekeeper 2
Timekeeper 3
Timekeeper 4
Electronic Timing Equipment Operator
Chief Judge
Finish Judge 1
Finish Judge 2
Finish Judge 3
Finish Judge 4
Race Judges
Safety Coordinator
Medical Officer
Course Officer
Volunteer 1
Volunteer 2
Volunteer 3
Volunteer 4

	Total	MSA Females	MSA Males	Non MSA Females	Non MSA Males
Number of Entrants
Number of Swimmers
Number of Swimmer under 18 years
Number of Swimmers who did not complete swim
Number of Swimmers who did not show for Swim

MSSA Open Water Swim Series Summary Report Form