ADMINISTRATIVE REMARKS
NAVPERS 1070/613 (REV. 08-2012)
PREVIOUS EDITIONS ARE OBSOLETE
SUPPORTING DIRECTIVE MILPERSMAN 1070-320
SHIP OR STATION:
NRD Richmond
SUBJECT:
PERMANENT
TEMPORARY
AUTHORITY (IF PERMANENT):
Underwater Breath Hold Training
CNRC Warrior Challenge Program
I acknowledge I have been briefed on the dangers of underwater breath holding and shallow water blackout.. I agree to not practice
or participate in underwater breath hold training while in the Delayed Entry Program. I understand there is no requirement for
underwater laps as an evaluation activity for acceptance into the Warrior Challenge Program.
If I become aware of other DEP Future Sailors practicing underwater breath hold training I agree to immediately intervene on site
and to contact the NRD Richmond Warrior Challenge Mentor Mark Negele and Coordinator SBCS(SWCC) James Sizemore by
phone to inform them of the incident.
Signature_____________________________________
ENTERED AND VERIFIED IN ELECTRONIC SERVICE RECORD:
VERIFYING OFFICIAL RANK OR GRADE/TITLE:
NAME (LAST, FIRST, MIDDLE):
DATE:
SIGNATURE OF VERIFYING OFFICIAL:
SOCIAL SECURITY NUMBER:
xxx-xx-
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USNavy
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