Basingstoke Bluefins Winter Championships 2005

Entry Form

* Surname:
* First Name:
* Sex: Male   Female
* Date of Birth:             Format   dd/mm/yyyy
Phone Number:
* eMail Address:
* Address: (Please include postcode)

 

Is this a replacement for an earlier entry? No  Yes

Please tick the boxes below against the events you wish to enter.
Event 50m 100m *1 200m 400m *1 800 *2 1500m *2
Freestyle
Backstroke      
Breaststroke      
Butterfly      
Ind Medley      

Fields marked with * are mandatory.

*1 - You may not enter both the 800m freestyle AND 1500m freestyle
*2 - There are no strokes for boys under 12 and girls under 11 in the following events: 100m all strokes, 800/1500m freestyle, 400m Ind Medley

When you have completed the form, click on Submit below. Before clicking on Submit, you must indicate that you accept the Promoters Conditions and confirm that the above information is accurate. The next screen will confirm the information that has been recorded and calculate the appropriate entry fee. If this information is incorrect, you will have the opportunity to cancel your entry and start again.

I confirm that I have read and accept the promoters conditions and that I am eligible for this competition. Yes    No

Please be patient when you click submit. Processing of the information may take some time.

To clear the form of all information to start again, click on the Reset button below.