<p>Form Reference R5.2.1 Changing 1st and/or Nominating or Changing 2nd Claim Club</p><p>Declaration by Applicant (Swimmer) Membership No:</p><p>Forename: Surname: Title:</p><p>DOB: (dd/mm/yyyy) Gender: Male Female</p><p>Postcode: House No:</p><p>Address:</p><p>Current 1st Claim Club:</p><p>Change my 1st Claim Club to: (Declarations A & B apply)</p><p>I wish to nominate a 2nd Claim club: (Declarations A (4) & D apply)</p><p>Current 2nd Claim Club:</p><p>Change my 2nd Claim Club to: (Declarations C & D apply)</p><p>I have read and understood the requirements of Company Rule R5.2.1. Swimming, Synchronised Swimming Masters and Open Water Swimming members can compete for their new club from the 1st of the month following receipt of this form by the Company.</p><p>Signature*: Applicant/Parent/Guardian Date: *For swimmers under 16 years the applicant (Swimmer) declaration must be signed by a parent or guardian. R5.2.1 An individual wishing to change their 1st or 2nd Claim Club must complete the appropriate form (available from the Company), and obtain the signature of the Secretaries, or other Club Officers, of the clubs involved. The form shall then be sent to the Company. R5.2.2 An individual shall be entitled to obtain the signature of a Club Secretary (or other Club Officer) or a reason for refusal within 14 days of the request being made. a) If no response is received by the individual within 14 days the individual can compete as unattached as per R4.5.5. b) If no response is received by the individual within 28 days the individual can compete for their new Club, provided they are not in breach of Section R4.5.5 or Sections R5.1.4 or R5.1.5. Notes: - 1. It is the responsibility of the Applicant (Swimmer) to have the appropriate Declaration Sections completed before submission to Scottish Swimming. 2. Change of Club form applies only to Swimmers and not to Non Swimmers. 3. It is the responsibility of the swimmer’s 1st Claim Club for ensuring that the SASA membership fee for the current year has been paid. 4. Once the Change of Club form details have been processed, Clubs and District Secretaries will be notified by the Company. 5. Membership and Change of Club details can be accessed online at the Home Country Membership check at www.scottishswimming.com </p><p>Declaration “A” by Current 1st Claim Club (Strike through what does not apply) 1. The applicant has / has not paid their Club and SASA membership for the current year.</p><p>1 March 2012 2. The applicant has / has not competed in Water Polo under the Club name during the current year (1st January to 31st December inclusive). 3. The applicant is free from all financial and other obligations to the club. 4. The club has no objections to this application.</p><p>Club Name: Date: (dd/mm/yy)</p><p>Signature Club Secretary: </p><p>Name Club Secretary:</p><p>Declaration “B” by New 1st Claim Club 1. The applicant is a member of the Club. 2. The Club has no objections to this application.</p><p>Club Name: Date: (dd/mm/yy)</p><p>Signature Club Secretary:</p><p>Name Club Secretary:</p><p>Declaration “C” by Current 2nd Claim Club (Strike through what does not apply) 1. The applicant has / has not paid their Club and SASA membership for the current year. 2. The applicant has / has not competed in Water Polo under the Club name during the current year (1st January to 31st December inclusive). 3. The applicant is free from all financial and other obligations to the club. 4. The club has no objections to this application.</p><p>Club Name: Date: (dd/mm/yy)</p><p>Signature Club Secretary:</p><p>Name Club Secretary:</p><p>Declaration “D” by New 2nd Claim Club 1. The applicant is a member of the Club. 2. The Club has no objections to this application.</p><p>Club Name: Date: (dd/mm/yy)</p><p>Signature Club Secretary: </p><p>Name Club Secretary:</p><p>Send the completed form to Scottish Swimming, National Swimming Academy, University of Stirling, Stirling, FK9 4LA For office use only: Form Received into Office Details checked & Confirmation sent to Confirmation sent to District computer record updated Club Secretaries Secretaries</p><p>Date: ____/____/____ Date: ____/____/____ Date: ____/____/____ Date: ____/____/____</p><p>1 March 2012</p>