Pool+Certificate+Template[2]

Pool Certificate Template MANHATTAN ISLAND FOUNDATION PO BOX 5533 NEW YORK, NY 10185 TELEPHONE: 888 NYC-SWIM FAX: 917-591-6213 WWW.NYCSWIM.ORG All pool certification swims must take place in a traditional swimming pool; "Endless Pool" swims are not acceptable for qualification purposes. Your pool swim must take place no earlier than March 1st of the current year, and all pool certifications and qualifying swim information must be received by MIF by the appropriate deadline. For qualification requirements and deadlines for each swim, see www.nycswim.org. All pool certificates must be submitted on the pool management stationery1 and signed by the witnessing lifeguard following the format below. Completed pool certificates may be uploaded to your profile (PDF format only) or faxed to 917591-6213. 1 If letterhead is not available, a business card for the pool’s or club's main contact person should be faxed to 917-591-6213 along with the completed pool certificate. Pool Letterhead Swim Information Swimmer Name: Swim Date: Distance Completed: (Specify yards or meters): Number of Laps Completed: Time to Complete Swim: (HH:MM:SS format) Pool Information Pool Name: Pool Specs: Length – specify yards or meters Pool Specs: Number of Lanes Pool Specs: Indoor or Outdoor Pool Address: Pool Telephone Number: Pool Website: Lifeguard Name: Lifeguard's Work Email: Lifeguard's Cell Number: (if available) Lifeguard Signature ___________________________________________