Swimathon2020_Entry

HIGHWORTH RECREATION CENTRE

SUNDAY 18 JUNE 2023
ENTRY FORM
Team name*
How many in your team?*
Your name (Team Captain)*

First NameLast Name
If you are under 18 please enter your date of birth

DayMonthYear
Your Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Your preferred contact phone number*

Area CodePhone Number
Your email address*
example@example.com
Enter your preferred start time: 10.30am, 11.30am, 12.30pm (subject to availablity) *

:HourMinutesAM/PM Option
Choose the charity or organisation your team is supporting. It will receive 50% of your team's sponsorship collections. If you do not choose one all the sponsorship you collect will go to SMASH, the Swindon-based charity chosen by us.
Charity or Organisation your team is supporting
Cheque payable to (if different from above)
IMPORTANT NOTICE - PLEASE READ BEFORE SUBMITTING THIS FORM

Swimathon Rules: Click here to read the rules of the Swimathon Submitting this entry form signifies your agreement that you and your team members will comply with these rules.

Photography: We take photographs at the Swimathon for publicity and promotional purposes. Your image and those of your team’s members and supporters may be captured in these photographs and may be published on our website, on social media pages and in the local media. Submitting this entry form signifies your consent.

You may withdraw your consent at any time by sending us an email using the Contact Us link on our website or by telephoning us on 07710 228697
Please confirm that you have read and understood the Important Notice above*

Tick to confirm
Should be Empty:

HIGHWORTH RECREATION CENTRE

ENTRY FORM