Clone of Clone of GSC Club Champs Summer Entry 2018

GSC Club Champs Summer 2018 Entry Form
Please ensure you complete all field marked with *

(any problems please e-mail gscmeetob@yahoo.co.uk
Swimmers First name*
Swimmers Surname*
ASA Number (if known)
Date of Birth*

DayMonthYear
Male/Female*
E-Mail Address (in case we have any queries)*
Phone number (no space)*

Choose your swims

	Tick to enter
25 Free (8/un only)
50 Free
100 Free
200 Free
25 Back (8/un only)
50 Back
100 Back
200 Back
25 Breast (8/un only)
50 Breast
100 Breast
200 Breast
25 Fly (8/un only)
50 Fly
100 Fly
200 Fly
100 IM
200 IM

Choose your swims

	Enter Time
25 Free (8/un only)
50 Free
100 Free
200 Free
25 Back (8/un only)
50 Back
100 Back
200 Back
25 Breast (8/un only)
50 Breast
100 Breast
200 Breast
25 Fly (8/un only)
50 Fly
100 Fly
200 Fly
100 IM
200 IM

Number of entries *
Total amount payable £3 per event up to a ceiling of £30*
Payment Method*

BACS (preferred)ChequeCash
Please press submit below when you have completed the entry form.
Your information will only be used for entry into this competition and for any queries which may arise. The form will be destroyed once the meet has taken place.
Should be Empty: