BARNET COPTHALL SWIMMING CLUB
AFFILIATED TO SCASA
10th MASTERS DISTANCE SWIM MEET
UNDER ASA LAWS
FRIDAY 24th & SATURDAY 25th JULY 1998
INDIVIDUAL ENTRY FORM
PLEASE USE BLOCK CAPITALS


FULL NAME...................................................................... DATE OF BIRTH............................

ADDRESS..............................................................................................................................

..........................................POST CODE................................ TEL No.....................................

MALE / FEMALE ........... CLUB..................................... A.S.A. Reg.........................................

PLEASE TICK APPROPRIATE AGE GROUP BOX (Age as at 31.12.98)
GROUPXAB CDEF GHJK LMNO
AGE 19-24 25-29 30-34 35-39 40-44 45-49 50-54 55-59 60-64 65-69 70-74 75-79 80-84 85-89 90+
Tick                    

NOTE: "MASTERS" must be at least 25 years of age IN THE YEAR OF COMPETITION
- that is, at least 25 by 31.12.98 - All competitors must be A.S.A. Registered.

PLEASE SUBMIT AN ENTRY TIME FOR EACH
EVENT REQUIRED IN THE APPROPRIATE
BOX TO THE RIGHT, EVEN IF IT IS ONLY AN
ESTIMATE.
"NO TIME" ENTRIES WILL BE PROGRAMMED
AT THE DISCRETION OF THE ORGANISER.
SWIMMER'S DECLARATION

I DECLARE THAT THE DETAILS GIVEN ABOVE
ARE CORRECT AND I AGREE TO ABIDE BY THE
ORGANISER'S CONDITIONS. I ALSO DECLARE
THAT I AM FIT, WELL AND ABLE TO COMPETE
IN MY CHOSEN EVENTS.

I ENCLOSE A CHEQUE, PAYABLE TO BARNET
COPTHALL S.C. IN THE SUM OF £..................

SWIMMER'S SIGNATURE..................................

ENTRY FEE - £2.25 PER EVENT

(SEE OVERLEAF TO PRE-ORDER PROGRAMME)
Ev. No Event TIME
FREESTYLE
23/24 100m
15/16 200m
3/4 400m
1/2 800m
BREASTSTROKE
5/6 100m
21/22 200m
BACKSTROKE
13/14 100m
7/8 200m
BUTTERFLY
19/20 100m
17/18 200m
IND. MEDLEY
9/10 200m
11/12 400m


CLOSING DATE FOR ENTRIES - FRIDAY 3rd JULY

Include 9" x 6" (or C5) S.A.E. for Time Cards and send to:-


IAN WOOLLARD, BARNET COPTHALL CENTRE, GT NORTH WAY, HENDON, LONDON, NW4 1PS
             FAX 0181 203 7512                  TELEPHONE 01707 654573