2009 Georgia Zone Team Application

The Southern Zone Champs will be held July 28 - August 3 in Orlando.  The Georgia Team will convene July 27 and return August 4 after the open water swim.  The cost for selected participants is $350.  Financial assistance can be made available in some cases. In order to be considered you must fill out the form below and send in a $50 deposit.  Once you have successfully submitted the form you will receive a confirmation that includes the address to send your deposit.   Your deposit must be received before Tuesday July 14th for 14&U/Disabled and Thursday July 21st for 15-18. 

Applicant's Last Name First Name

Birth date      GenderMale Female

USAS Number   Club

Age Group as of July 28, 2009  Choose One Disabled Swimmer 11-12 13-14 15-18

Parent or contact name

Address

City   Zip

Phone Emergency phone

Contact Email

Suit Size Choose one 24 26 28 30 32 34 36   T-Shirt Size Choose one Adult Small Adult Medium Adult Large Adult XL

Please read the zone selection policy below and then confirm you have read it using the button below.

1. Each swimmer that wants to be considered for the zone team must complete an on-line registration and send in a $50 deposit, (check payable to GA Swimming). 2. Time trials and lead-off splits will not be considered in the selection process. 3. The scoring process will only involve swimmers being considered for the zone team. Up to 4 automatic berths are given to the winners of the 100s of each stroke. The remaining slots will be chosen based on scoring. See the State Champs meet announcment for complete details. 4. The $50 deposit will be refunded if the swimmer fails to make the team. If the swimmers makes the team the deposit will be used down payment. The deposit will be forfeited if the swimmer chooses to opt out of the selection process after the deposit is received.

I have read and agree to the selection policy. 

Parent would like to be considered for chaperone.