Individual entry for Online PAYPAL Test - Ignore

This page is for non Members only. Members should enter using the members link on the meet information page.

Please insert your entry time into the box of the event(s) that you want to enter.

The time that you enter MUST be in the below format:
e.g. 1 Minute, 45 seconds and 30 milliseconds would be 014530

If you do not want to enter the event, please leave it blank.

When this form is complete please press submit, and your entry will be submitted

***PLEASE NOTE - YOU MAY NOT BE ELIGIBLE TO ENTER ALL EVENTS, PLEASE CHECK THE CONDITIONS AND EVENT SCHEDULE***

First Name:Club:
Last Name:
Date of Birth:Gender:
Email:ASA Membership Number:
Phone Number:Mobile Number:
EventTime
25m Freestyle
25m Backstroke
25m Breaststroke
25m Butterfly
Disclaimer:
By ticking this box you agree that we may publish your personal information as part of the results of the event and may pass such information to the governing body or any affiliated organisation for the purpose of insurance, licences or for publishing results. Results may include (but not be limited to) name, any club affiliation, membership mumber, times and date of birth. You also agree that we may use the contact details you have provided to contact you about this event.






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