Language
English (UK)
Swim Ireland Registration
Kilkenny Swimming Club 2021/2022
Swimmers Name
*
First Name
Last Name
Date of Birth
*
-
Day
-
Month
Year
Date
Address
*
Street Address
Street Address Line 2
Town
County
Eircode
The Swimmere would like to register with Swim Ireland?
Yes
No
Parent / Guardian Name
*
First Name
Last Name
Parent Mobile Phone Number
*
e.g. 0851234567
Parent Email
*
example@example.com
Payment due
*
(Number of races * per race fee)
Payment Due
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Description
Credit Card Details
First Name
Last Name
Credit Card Number
Security Code
Card Expiration
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