Fun 500 and Challenge 2000 - 2016
Relay Entry - [Team Manager Details - Page 1]

Swimming Club


Title

First Name

Last Name

Please use name you have registered with ASA, e.g. if known as Dave but registered as David please use David

House number and Street

Post Town

Full Address and PostCode, that can be used for correspondence

County

PostCode


Telephone Number

Mobile Number

Telephone and mobile numbers, that can be used for correspondence. Email address will be used to send out information on current and future events.

Email Address:



Emergency Name

Emergency Phone

Person the Organisors can contact using the telephone number given if a medical condition occurs




Page 1 - enter your team details.

Page 2 - select events and number of teamName.

Page 3 - confirms selected events, saves your details and allows you to progress to PayPal.

PayPal - allows you to pay with a PayPal account or using a Debit or Credit card. You will then be sent a confirmation email from PayPal.

Cheque - if you do not wish to pay online, you can pay by cheque, please contact the organisors for more details.

T and C - Please ensure you read the Tterms and Conditions below.

Please verify your entries and monies due.

We have chosen Paypal (an eBay Company), because it has a superior level of security for payment over the internet.
It will be necessary to register with Paypal the first time you create your account

When you have completed your payments on the next menu page, please select the option to allow PayPal to return you to SwimNorthwest.org on completion of you payment, this will allow us to finalise your entry details and payment details together

Please verify your entries and monies due.

We have chosen Paypal (an eBay Company), because it has a superior level of security for payment over the internet.
It will be necessary to register with Paypal the first time you create your account

When you have completed your payments on the next menu page, please select the option to allow PayPal to return you to SwimNorthwest.org on completion of you payment, this will allow us to finalise your entry details and payment details together