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Please fill out the following form to register your intention to swim or withdraw for all 400m, 800m and 1500m events.
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1
Swimmer Name
*
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First Name
Last Name
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2
Date of Birth
*
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Date
Day
Month
Year
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3
Contact Email
*
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example@example.com
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4
Club
*
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5
Meet you are registering your intention for:
*
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2025 LC Preparation Meet #1
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6
Which event are you registering your intent for?
Female 400m Individual Medley
Female 800m Freestyle
Female 1500m Freestyle
Male 400m Individual Medley
Male 800m Freestyle
Male 1500m Freestyle
Other
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7
Are you intending to swim this event?
*
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YES
NO
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8
Please confirm in writing that you are withdrawing from this event.
*
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9
Name of Person Completing Form
*
This field is required.
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10
Contact Number for Person Completing Form
*
This field is required.
Please enter a valid mobile phone number.
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11
Signature of person completing form
*
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Clear
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Should be Empty:
Confirm Intent to Swim - Distance Events
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