Unit Swim Classification Record - Michigan Crossroads Council

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Unit Swim Classification Record
This is the individual’s swim classification as of this date. Any change in status after this date
(i.e., nonswimmer to beginner or beginner to swimmer) would require a reclassification test
performed by an approved test administrator. Changes and corrections to the following chart
should be initialed and dated by the test administrator.
SPECIAL NOTE: When swim tests are conducted away from camp, the camp aquatics director
retains the right to review or retest any or all participants to ensure that standards have been
maintained.
Unit Number _________________
Date of Swim Test _______________
Full Name (Print)
Swim Classification
Medical
Recheck
Nonswimmer
Beginner
Swimmer
(Draw lines through blank spaces.)
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
NAME OF PERSON CONDUCTING THE TEST:
(Person must be approved by the MCC Aquatics Chair)
_______________________________________
_______________________________________
Print Name
Signature
_______________________________________
_______________________________________
Qualification
Council/Agency (Red Cross, YMCA, etc.)
UNIT LEADER:
______________________________________
____________________________________
Print Name
Signature
430-122
(OVER)
Revised: March 2009
Please send a copy of the completed form to: MCC Aquatics Chair, 137 S Marketplace Blvd, Lansing MI 48917

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