Sbr Swim Test
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2Swim Test Master List
Expedition #:
Unit & Unit #:
____________
__________________
UNIT LEADER INSTRUCTIONS: All participants must complete a BSA Annual Swim test to participate in Summit programs. Use
form 430‐122 ( ,
supervision requirements, and to record the results.
If your unit will not be completing the swim test at the same time and location, you can use this form to consolidate swim test
results as follows:
1)
Provide each youth and adult participant a copy of Form 430‐122.
2)
Each participant completes the prescribed swim test under qualified supervision. (see Form 430‐122)
3)
Collect forms from all youth and adult participants. Transfer the results to this master sheet.
4)
File the original swim test records with your unit records and bring this form with you to the Summit.
The following participants are classified as BSA SWIMMERS. DO NOT list non-swimmers or
beginner swimmers on the list below. Date of swim test MUST be within one year of
participation.
DATE OF SWIM
FULL NAME (PRINT)
TEST
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Please list Beginners and Non-Swimmers on the back
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