2025 Ozark LMSC SCM Championship Meet Entry -

ENTRY DEADLINE is FRIDAY, NOVEMBER 14, 2025 at 12:00pm NOON

Below is the entry form for the 2025 Ozark LMSC Short Course Meters (SCM) Championship Meet being held Saturday, November 15, 2025 at the Chuck Fruit Aquatic Center, 6168 Center Grove Rd, Edwardsville, IL 62025.

ATTENTION: Read the Swim Meet Information and USMS Participant Waiver r.10/30/24, as you must indicate acceptance of the USMS Participant Waiver to authorize your meet entry.

swim meet info & waiver here

2025 Ozark LMSC Short Course Meters Championship Entry:

Last Name *

As shown on USMS membership card.

First Name *

As shown on USMS membership card.

2025 or 2026 USMS Number *

Full nine digits - XXXX-XXXXX

Birthdate *

Age Group *

drop down menu

Gender (M/F) *

Phone

Email *

Emergency Contact Name *

Emergency Contact Phone *

Relays

4 - M, W, or X (mixed) 200 Medley Relay
8 - M, W, or X (mixed) 400 Free Relay
11 - M, W, or X (mixed) 800 Free Relay
15 - M, W, or X (mixed) 200 Free Relay
21 - M, W, or X (mixed) 400 Medley Relay

Please mark if you are interested in competing in relays. Send any team lineups to Jeff Enge (jpenge358@gmail.com); otherwise, Meet Director will contact interested swimmers to set up relay teams prior to the meet. NO Relay deck entries will be accepted.

Volunteer Interest

Volunteers

Check this box if you have friends/family able and interested to volunteer as timers or pre-meet organization.

USMS Participant Waiver and Release of Liability Electronic Signature *

Check Here for Acceptance

By entering the 2025 Ozark LMSC Short Course Meters Championship swim meet, I declare that I have read the waiver and agree that Online Entry includes Electronic Signing of the USMS Participant Waiver (r.10/30/2024)

Meet Entry Fee

Meet Entry - $30.00

Total

$0.00

PayPal Commerce *

Card Number

Expiration Date

Security Code

Card Holder Name