USA Swimming USA Swimming USA Swimming

USA Swimming USA Swimming USA Swimming

Relay Take Off Judge Relay Take Off Judge Relay Take Off Judge

EVENT# ____ HEAT# ____ EVENT# ____ HEAT# ____ EVENT# ____ HEAT# ____

(Circle one: SIDE or LANE) (Circle one: SIDE or LANE) (Circle one: SIDE or LANE)

0 = GOOD X = BAD 0 = GOOD X = BAD 0 = GOOD X = BAD

Swimmer Number Swimmer Number Swimmer Number

Lane 1 2 3 4 Lane 1 2 3 4 Lane 1 2 3 4

Lane 2 2 3 4 Lane 2 2 3 4 Lane 2 2 3 4

Lane 3 2 3 4 Lane 3 2 3 4 Lane 3 2 3 4

Lane 4 2 3 4 Lane 4 2 3 4 Lane 4 2 3 4

Lane 5 2 3 4 Lane 5 2 3 4 Lane 5 2 3 4

Lane 6 2 3 4 Lane 6 2 3 4 Lane 6 2 3 4

Lane 7 2 3 4 Lane 7 2 3 4 Lane 7 2 3 4

Lane 8 2 3 4 Lane 8 2 3 4 Lane 8 2 3 4

Lane 9 2 3 4 Lane 9 2 3 4 Lane 9 2 3 4

Lane 10 2 3 4 Lane 10 2 3 4 Lane 10 2 3 4

______

Signature Signature Signature

USA Swimming USA Swimming USA Swimming

Relay Take Off Judge Relay Take Off Judge Relay Take Off Judge

EVENT# ____ HEAT# ____ EVENT# ____ HEAT# ____ EVENT# ____ HEAT# ____

(Circle one: SIDE or LANE) (Circle one: SIDE or LANE) (Circle one: SIDE or LANE)

0 = GOOD X = BAD 0 = GOOD X = BAD 0 = GOOD X = BAD

Swimmer Number Swimmer Number Swimmer Number

Lane 1 2 3 4 Lane 1 2 3 4 Lane 1 2 3 4

Lane 2 2 3 4 Lane 2 2 3 4 Lane 2 2 3 4

Lane 3 2 3 4 Lane 3 2 3 4 Lane 3 2 3 4

Lane 4 2 3 4 Lane 4 2 3 4 Lane 4 2 3 4

Lane 5 2 3 4 Lane 5 2 3 4 Lane 5 2 3 4

Lane 6 2 3 4 Lane 6 2 3 4 Lane 6 2 3 4

Lane 7 2 3 4 Lane 7 2 3 4 Lane 7 2 3 4

Lane 8 2 3 4 Lane 8 2 3 4 Lane 8 2 3 4

Lane 9 2 3 4 Lane 9 2 3 4 Lane 9 2 3 4

Lane 10 2 3 4 Lane 10 2 3 4 Lane 10 2 3 4

______

Signature Signature Signature

USA Swimming USA Swimming USA Swimming

Relay Take Off Judge Relay Take Off Judge Relay Take Off Judge

EVENT# ____ HEAT# ____ EVENT# ____ HEAT# ____ EVENT# ____ HEAT# ____

(Circle one: SIDE or LANE) (Circle one: SIDE or LANE) (Circle one: SIDE or LANE)

0 = GOOD X = BAD 0 = GOOD X = BAD 0 = GOOD X = BAD

Swimmer Number Swimmer Number Swimmer Number

Lane 1 2 3 4 Lane 1 2 3 4 Lane 1 2 3 4

Lane 2 2 3 4 Lane 2 2 3 4 Lane 2 2 3 4

Lane 3 2 3 4 Lane 3 2 3 4 Lane 3 2 3 4

Lane 4 2 3 4 Lane 4 2 3 4 Lane 4 2 3 4

Lane 5 2 3 4 Lane 5 2 3 4 Lane 5 2 3 4

Lane 6 2 3 4 Lane 6 2 3 4 Lane 6 2 3 4

Lane 7 2 3 4 Lane 7 2 3 4 Lane 7 2 3 4

Lane 8 2 3 4 Lane 8 2 3 4 Lane 8 2 3 4

Lane 9 2 3 4 Lane 9 2 3 4 Lane 9 2 3 4

Lane 10 2 3 4 Lane 10 2 3 4 Lane 10 2 3 4

______

Signature Signature Signature