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?

Yes

No

Please provide an explanation as to why the parent/legal guardian is not aware of this request

Information of individual completing this form

First Name: *

Last Name: *

Email Address: *

Phone Number *

USA Swimming Athlete Information:

Which of the following applies to the athlete? *

The athlete is a current member of USA Swimming who wishes to change the competition category in which they participate.

The athlete is a former member of USA Swimming who wishes to join USA Swimming as a member and register in a competition category different than the biological gender assigned to the athlete at birth.

The athlete has never been a member of USA Swimming who wishes to join USA Swimming as a member and register in a competition category different than the biological gender assigned to the athlete at birth.

Athlete’s name as currently registered with USA Swimming:

First Name: *

Middle Name:

Last Name: *

Athlete’s name as previously registered with USA Swimming:

First Name: *

Middle Name:

Last Name: *

Joining Athlete’s name :

First Name: *

Middle Name:

Last Name: *

Is the athlete requesting a name change with USA Swimming? *

Yes

No

If Yes, Please specify

First Name:

Middle Name:

Last Name:

Athlete’s current competition category (or competition category prior to joining/completing the Self-Identity Verification process): *

Male

Female

Athlete’s requested competition category: *

Male

Female

Athlete’s USA Swimming Member ID

Athlete's Age *

Athlete's Club:

Athlete's LSC:

Has the athlete previously requested a competition category change request? *

Yes

No

If yes, was the competition category change request granted?

Yes

No

If Yes, please specify date previous request was granted: (MM/DD/YYYY) +

If no, please specify date previous request was denied: (MM/DD/YYYY) +

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?

Any United States Olympic and Paralympic Committee (“USOPC”) Delegation Event and/or Protected Competition as defined in the USOPC Bylaws

Fédération Internationale de Natation (“FINA”) Events

PanPacific Championships

World University Games

USA Swimming Nationals

Junior Nationals

U.S. Open

International Team Trials

U.S. Olympic Team Trials - Swimming

Club Contact

Club Head Coach Name:

Athlete’s Group Coach Name (if different from Club Head Coach):

Is the athlete’s club/coach aware of this request?

Yes

No

Are there concerns with USA Swimming contacting the athlete’s club about this request? *

Yes

No

If Yes, Please specify:

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)?

Yes

No

If yes, would you be willing to share the professional’s name and contact information?

Yes

No

Healthcare Professional Contact Info:

First Name

Last Name

Street Address

Address Line 2

City

State

Zip Code

Phone Number

Email Address

Please feel free to attach any other pertinent documentation or information you believe to be relevant and appropriate to this Request: (Up to 5 documents)

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

Typed Full Name *

Signature *

clear

Date (MM/DD/YYYY) * +

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