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DISQUALIFICATION REPORT

EVENT NO: _____________ EVENT: _____________________

HEAT/ TIME FINAL NO: ________________________________

(PLEASE CIRCLE THE APPROPRIATE)

LANE: 1 2 3 4 5 6 7 8

REASON (s)

STROKE / KICK/ TOUCH TURN/ BODY POSITION/ START

__________________________________________________________
__________________________________________________________
__________________________________________________________
__________________________________________________________
__________________________________________________________

JUDGE : ________________________

C.I.T / I.T : ________________________

REFEREE : ________________________
DISQUALIFICATION REPORT

EVENT NO: _____________ EVENT: _____________________

HEAT/ TIME FINAL NO: ________________________________

(PLEASE CIRCLE THE APPROPRIATE)

LANE: 1 2 3 4 5 6 7 8

REASON (s)

STROKE / KICK/ TOUCH TURN/ BODY POSITION/ START

__________________________________________________________
__________________________________________________________
__________________________________________________________
__________________________________________________________
__________________________________________________________

JUDGE : ________________________

C.I.T / I.T : ________________________

REFEREE : ________________________
DISQUALIFICATION REPORT

EVENT NO: _____________ EVENT: _____________________

HEAT/ TIME FINAL NO: ________________________________

(PLEASE CIRCLE THE APPROPRIATE)

LANE: 1 2 3 4 5 6 7 8

REASON (s)

STROKE / KICK/ TOUCH TURN/ BODY POSITION/ START

__________________________________________________________
__________________________________________________________
__________________________________________________________
__________________________________________________________
__________________________________________________________

JUDGE : ________________________

C.I.T / I.T : ________________________


REFEREE : ________________________

DISQUALIFICATION REPORT

EVENT NO: _____________ EVENT: _____________________

HEAT/ TIME FINAL NO: ________________________________

(PLEASE CIRCLE THE APPROPRIATE)

LANE: 1 2 3 4 5 6 7 8

REASON (s)

STROKE / KICK/ TOUCH TURN/ BODY POSITION/ START

__________________________________________________________
__________________________________________________________
__________________________________________________________
__________________________________________________________
__________________________________________________________

JUDGE : ________________________

C.I.T / I.T : ________________________

REFEREE : ________________________

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