SWIMMING VICTORIA (METRO NORTH) ENTRY CARD

To: Competition Committee
P.O. Box 571
Greensborough VIC 3088
$3.50 per event
Cash / Cheques payable to
Swimming Victoria Metro North Inc.

SWIM MEET:

Date of Meet

Last Name:

First Name:

Club:

Reg. No.

Date of Birth

Age as of 1st day of Meet:

Male / Female (Please Circle)

Where entry time was achieved

Ev No

Stroke

Entry Time

Date

Meet Name

Pool 25m / 50m

.

.

.

.

.

.

.

.

.

.

.

.

.

.

.

.

.

.

.

.

.

.

.

.

.

.

.

.

.

.

.

.

.

.

.

.

.

.

.

.

.

.

.

.

.

.

.

.

.

.

.

.

.

.

.

.

.

.

.

.

Declaration:
I am currently a registered member of of the club shown above (registration runs from 1 May to 30 April).
I am aware that Swimming Victoria will not accept this as an Entry Card.

Signature:

Contact phone number:

Address:

Postcode: