USA Swimming requires anyone applying for coach membership to provide proof of current certification in CPR/AED and Safety Training for Swim Coaches (STSC). These courses include skill demonstrations that people with certain disabilities may be unable to participate in. In this event, the coach candidate should follow these procedures:
1. Obtain current certifications in any of the two courses where his/her disability is not a factor. Certifications must be from the list of USA Swimming approved courses.
2. Take the remaining course(s) and complete the written exam.
3. Obtain a letter from the organization that administered the course(s) stating that the candidate passed the written exam(s) but was unable to participate in the skills demonstration portion of the exam(s) due to a physical disability. Letters should be submitted to the LSC Membership Chair.
4. Submit a letter to the LSC Membership Chair from the club’s head coach or board president stating that a lifeguard or another USA Swimming coach will also be on deck at all times.
The following Local Swimming:
Issues this waiver to the individual named below: 
who, due to a physical disability, is exempted from participating in the skills demonstration exam(s) required to pass the following course(s):
What courses does the waiver cover?
Name of Course
Name of Course
Name of Course
The individual named below is eligible for coach membership in USA Swimming provided that all of the following conditions are met:
✔  Candidate has current USA Swimming-approved certifications where a waiver is not necessary

✔  Candidate can provide proof of having passed the written exam(s) for those courses where a waiver is necessary (CPR/AED and/or STSC) in the form of a letter from the course instructor verifying that the candidate has a disability that prohibits him/jer from comleting the required skills demonstration;

✔  Candidate agrees to provide a copy of the waiver to the LSC at any time

✔  A letter from the USA Swimming club verifying that a lifeguard or another USA Swimming coach member is on deck at all times

The coach candidate must prove to the LSC Membership Chair that all of the above conditions have been met.  At that time, coach membership can be granted by the LSC.
Waiver has been issued on the date below, and expires on date of said certification.
LSC Membership Chair (type in name)