Swim Meet Scratch Request Form
Submit this form to request scratching an athlete from one or more swim meet events. Please complete all required details for accurate processing.
Swimmer's Full Name
*
First Name
Last Name
Swimmer's Date of Birth
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Team/Club Name
*
Swim Meet Name
*
Swim Meet Date
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Event(s) to Scratch
*
50 Freestyle
100 Freestyle
200 Freestyle
50 Backstroke
100 Backstroke
50 Breaststroke
100 Breaststroke
50 Butterfly
100 Butterfly
200 Individual Medley
Other (please specify below)
If 'Other', please specify event(s)
Reason for Scratch
*
Requestor's Name
*
First Name
Last Name
Relationship to Swimmer
*
Please Select
Self
Parent/Guardian
Coach
Other
Contact Email
*
example@example.com
Submit Scratch Request
Should be Empty: