Central Illinois Masters Swim Team, Inc.

Trial Workout

Step 1 of 3

Biographical
Waiver
Payment
Payment
Receipt

To participate in a free 30 day trial with CIMST please do the following:
1- Complete this ONLINE Trial Workout form.
2- Print the USMS 30-Day Tryout Guest Membership Application, click here. Bring the completed and signed form with you to your first workout.

* Starred fields are required

First Name *

Preferred (Nickname)

Middle Name

Last Name *

Birth Date

Phones

Home

Work

Cell *

Texting Cell

Mobile provider

Email *

Country *

Street *

Street 2

City *

State *

ZIP Code *

2024 U.S. Masters Swimming (USMS)

USMS Club

Member ID

Use all 10 digits, i.e. 3348-0000A
Register for USMS | Retrieve USMS ID

Emergency Contact

Name *

Relation

Phone *

Name 2 *

Relation 2

Phone 2 *

What is your competitive swimming background / experience?

Beginner

High School

College

Former Masters Swimmer

Triathlon

What are your swimming goals?

Trial Workout Information

Date Attend

(mm/dd/yyyy)

Facility attend

Holiday Pool, Bloomington IWU Shirk Center, Bloomington Four Seasons I, Bloomington Octavia Park Pool, Colfax Glasener Beach at Comlara Park, Hudson Bloomington High School other