Basingstoke Bluefins Easter Egg Meet 2005

Saturday March 26th 2005

Entry Form

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

 
Is this a replacement for an earlier entry? No  Yes

Please tick the boxes below and enter your time against the events you wish to enter. If you do not have a time, enter NT. 
Event Entry Time
50m Freestyle
50m Breaststroke
50m Backstroke
50m Butterfly

Fields marked with * are mandatory.

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.