DARLINGTON DOLPHIN MASTERS A.S.C.
(AFFILIATED TO N & D)
13 MARCH 1999 AT THE DARLINGTON DOLPHIN CENTRE
ENTRY FORM
CLOSING DATE 13th FEBRUARY 1999
Please send entry forms to:
Mrs. Judith Vinton, 10 Barmpton Lane, Darlington DL1 3HB
Tel 01325 281649
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Name |
Sex |
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Address |
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Postcode |
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Tel No |
Date of Birth |
Club |
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Reg No |
Age Group |
Signature |
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Please enter times against individual events entered (25m pool) |
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25m Freestyle |
4 x 1 Medley |
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50m Freestyle |
100m Freestyle |
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50m Backstroke |
100m Backstroke |
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50m Breaststroke |
100m Breaststroke |
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50m Butterfly |
100m Butterfly |
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Please complete this section only if you are enclosing the team entry fees. Please enter number of teams entered against each event, and indicate male or female. |
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120 Freestyle |
160 Freestyle |
200 Freestyle |
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120 Medley |
160 Medley |
200 Medley |
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150 Mixed Freestyle |
150 Mixed Medley |
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Entry fee £2.00 per event, £5.00 per team. Cheques made payable to Darlington Dolphin Masters A.S.C.
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Photocopies Accepted |
Amount enclosed: |
Individual |
£ |
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Teams |
£ |
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Please Enclose LARGE S.A.E. |
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TOTAL |
£ |