ENTRY FORMS ARE AVAILABLE FROM AND SHOULD
1999 OPEN MASTERS
BE RETURNED TO:-
& 19 - 24yrs AGE GROUP
Mr. D. Dickenson
(Under A.S.A. Laws)
56 Quarry Lane
Sheffield, S11 9EB
to be held at North Bay Indoor Pool Scarborough
Tel &fax. 01142-815488
on Saturday 8th May 1999
FULL NAME _____________________________________
DATE of BIRTH _______________
ADDRESS ___________________________________________
MALE/FEMALE _______________
POST CODE _____________________
NAME OF CLUB (IN FULL) __________________________________
REG.No. _________________
PLEASE TICK APPROPRIATE AGE-GROUP (Age as at 31/12/99)
| Group | A | B |
C | D | E | F |
G | H | J | K |
L |
| Ages | 25-29 | 30-34 | 35-39 |
40-44 | 45-49 | 50-54 | 55-59 | 60-64 |
65-69 | 70+ | 19-24 |
| X | | | | |
| | | | |
| |
| EVENT | SUBMITTED TIME (25m) |
|
EVENT | SUBMITTED TIME (25m) |
| 50m Freestyle | |
|
50m Breaststroke | |
| 100m Freestyle | |
|
100m Breaststroke | |
| 200m Freestyle | |
|
50m Butterfly | |
| 50m Backstroke | |
|
100m Butterfly | |
| 100m Backstroke | |
|
100m Ind/Medley | |
CLUB RELAYS
RELAY EVENTS SHOULD BE SUBMITTED BY ONLY ONE PERSON FROM YOUR CLUB TO ENTER SIMPLY TICK THE RELEVENT
BOX(ES)
NAME OF CLUB IN FULL ......................................................................
MEN
WOMEN
| EVENT |
120yrs + | 160yrs + | 200yrs + |
|
120yrs + | 160yrs + | 200yrs + |
| 4 x 25m Freestyle Team |
| | |
|
| | |
| 4 x 25m Medley Team |
| | |
|
| | |
Declaration (This declaration must be signed and the appropriate entry fees must accompany this form).
I declare that the above particulars are correct and agree to
abide by the Promoter's conditions as laid down in the Information Sheet for this
event.
Signature of Competitor .........................................................................
ENTRY FEE : INDIVIDUAL: £2.50 TEAM: £6.00
STAMPED ADDRESSED ENVELOPE PLEASE
Cheques made out to Yorkshire A.S.A.