ENTRY FORM - 2017.

ENTRY FORM

I

SWIMMERS NAME:________________________________________

COUNTRY:_______________________________________________

DATE OF BIRTH:___________________________________________

NAME OF SWIMMING CLUB:________________________________

ADDRESS:________________________________________________

TELEPHONE(FAX):_________________________________________

GSM (MOBILE PHONE):_____________________________________

E-MAIL ADDRESS:_________________________________________

NAME OF COACH:_________________________________________

BEST PERFORMANCES: _____________________________________

________________

DATE SIGNATURE

_______________________ _____________________

NATIONAL FEDERATION OR

SWIMMING CLUB (SIGNATURE AND STAMP)______________________

*PLEASE RETURN TO THE ORGANIZING COMMITTEE BEFORE JULY 30th 2017 BY MAIL, FAX OR E-MAIL.

 

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