COMMUNITY ROWING INC. SWIM TEST CARD

Instructions:

1. Write Name of Participant on the Swim Test Card;

2. Have a certified Lifeguard/Water Safety Instructor observe you and complete form below;

3. Make a copy of your card for your records;

4. Bring the card the first day of program; or mail a copy to:

Community Rowing
600 Pleasant Street
Watertown , MA 02472

Name of Participant/Rower: _________________________________________________

Name of Lifeguard/Water Safety Instructor: _____________________________________

Name of Pool: ____________________________________________________________

Phone Number of Pool: ____________________________________________________

Swim Test Certification :

I hereby certify that the participant can swim 100 yards in a competent manner and can remain afloat for at least 5 minutes.

Signature of Lifeguard/Water Safety Instructor: __________________________________

Date of Test: ___________________________

Only swim tests completed in 2005, 2006, 2007 or 2008 are valid for the 2008 season.

Keep a copy of the completed test for your records