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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