LAKE ERIE SWIMMING
TRANSFER APPLICATION

ATHLETE NAME (L) _________________________(F)__________________(M)  __________

STREET_______________________________________________________________________

CITY_________________________STATE __________ ZIP _________PHONE ___________

BIRTHDATE _____________________   SEX    M   F        USA NUMBER ________________

OLD CLUB NAME  ___________________________________________ 
             (Give city, state and LSC is club is not in Lake Erie)

NEW CLUB NAME __________________________________________

MUST COMPLETE BOX BELOW BEFORE SUBMITTING APPLICATION

LAST DATE REPRESENTING OLD CLUB:

NAME OF MEET  _________________________   DATE: _________

I understand that in order for me to represent my new USA club in a competitive event, 120 consecutive days must have elapsed without having represented any other USA club in USA competition.  I also certify that I have no outstanding fees or debts with my old club and the above information is true and correct to the best of my knowledge and belief.

SIGNATURE  ________________________________________
                         (athlete, parent or guardian signature)

NOTE:  Your new club will be notified of the date you may attach with them.  Those swimmers transferring to UNATTACHED	 status will be transferred immediately.

Either email form to pamswim@aol.com or send the form through regular mail to:

	Pam Cook
	301 Rockledge Dr.
	Bay Village, OH  44140
	440-808-9192

NO FEE