WCR-B Swim Test Form


PO Box 750036,
Arlington, MA 02475

SWIM TEST Form Instructions:

  1. Write Name of Participant on the Swim Test Form;
  2. Have a certified Lifeguard/Water Safety Instructor observe you and complete form below;
  3. Make a copy of your form for your records; 4) Bring the form on the first day of program.

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: ___________________________

Keep a copy of the completed test for your records