Lake Merritt Rowing Club

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Membership Information
LMRC Swim Test Form

Name:______________________________________
Address:______________________________________
______________________________________
Day Phone:______________________________________
Evening Phone:______________________________________
E-mail Address:______________________________________

SWIM TEST FORM

I certify that the above named person has passed the following swimming ability requirements in my presence:

1. Swim a distance of 75 feet.

2. Tread water for five minutes.

3. Swim under water for a distance of 20 feet.

______________________________________ Date:_________________
WSI or Equivalent Signature

Pool:_________________

______________________________________
Red Cross Chapter

______________________________________
WSI or Equivalent Expiration Date


Swim Test Form in PDF


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Last modified: May 02 2007 07:01:02 am:

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