USA Swimming Athlete Gender Inclusion, Competitive Equity and Eligibility Self-Identity Verification Request

[Note: For a Request involving an athlete under the age of 18, this Request form must be completed by the athlete’s parent/legal guardian.]

Individual Completing this Request Form:
Relationship to athlete (select): *
 
If not the athlete or athlete’s parent/legal guardian, please provide the following: Is the athlete’s parent/legal guardian aware of this request?
Information of individual completing this form
USA Swimming Athlete Information:
Which of the following applies to the athlete? *
Athlete’s name as currently registered with USA Swimming:
Athlete’s name as previously registered with USA Swimming:
Joining Athlete’s name :
Is the athlete requesting a name change with USA Swimming? *
If Yes, Please specify
Athlete’s current competition category: *
Athlete’s requested competition category: *
Has the athlete previously requested a competition category change request? *
If yes, was the competition category change request granted?
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Elite Athlete/Event Information
Has the athlete achieved a time standard which would qualify the athlete for any of the following competitions in the requested competition category? If yes, which one?
Club Contact
Is the athlete’s club/coach aware of this request?
Are there concerns with USA Swimming contacting the athlete’s club about this request? *
Optional Information
Is the athlete being treated by a licensed healthcare professional(s) (e.g., family physician, endocrinologist, pediatrician, psychiatrist, psychologist, or licensed mental health professional)?
If yes, would you be willing to share the professional’s name and contact information?
Healthcare Professional Contact Info:

Consent and Release
By submitting this Self-Identity Verification Request the athlete, and/or the athlete’s parent/legal guardian, as applicable, represents and agrees that:
(a) All information submitted in connection with the Request is accurate and complete to the best of their knowledge and that no relevant information has been intentionally withheld.
(b) The athlete will fully cooperate with and provide any additional information requested by USA Swimming and/or the Self-Identity Verification Panel.
(c) Neither USA Swimming,  the Self-Identity Verification Panel or any member thereof, nor any USA Swimming employees, directors, officers, agents, representatives, or other persons involved in the administration of the applicable Policy shall be liable in any way in relation to acts done or omitted to be done in good faith in connection with the administration of the applicable Policy
Signature *
clear
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If the athlete would also like to request a waiver of USA Swimming's swimwear rules in conjuction with this request, such a request must be submitted separtely to the Chair of the Rules and Regulations Committee at swimrulesandregs@gmail.com.
Please note:
1. Exemption requests must specifically purpose for seeking an exemption and any pertinent supporting documentation.
2. Exemptions will only be granted for the swimsuit coverage requirements. An exemption may be granted for: (1) a swimsuit that covers less or more of the body than permitted under 102.8.1B; or (2) the use of a separate garment worn underneath a regular swimsuit. A swimsuit or garment for which an exemption has been granted must meet all other swimsuit technical requirements established by FINA, including, but not limited to, the prohibition against the use of zippers or other fastening devices, the requirement that the swimsuit be made of full textile materials and the requirement that the suit not give the swimmer a competitive advantage.
3. All exemptions are effective only for the calendar year in which they are granted and must be renewed annually using the procedures provided herein.
4. It is the responsibility of the swimmer to present a copy of the exemption letter to the meet referee prior to the start of the meet in which the swimmer intends to participate.
For any questions or concerns while completing this form, please contact SIV@usaswimming.org
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