3RD USF NATIONAL INTER-CLUB SWIMMING CHAMPIONSHIPS
10 – 11 JUNE 2017, KISU
TEAM ENTRY CONFIRMATION FORM
Club Name:
No. Name
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
15.
16.
17.
18.
19.
20.
No. Name
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
FEMALE SWIMMERS
Age Group Date of Birth
MALE SWIMMERS
Age Group Date of Birth
This form is to be returned NO LATER THAN 26 May 2017 to the Organizing
Committee Via mail at [email protected] with a copy to
[email protected] and [email protected]
15.
16.
17.
18.
19.
20.
No. Name
1.
2.
3.
CLUB OFFICIALS
M/F Function/Role
Submitted by Authorized Club Personnel
Name:
_______________________________
Position in Club: _______________________________
Date:
_______________________________
NOTE:
A participating Club will be required to submit the Final Team
Entry Confirmation Form in case changes in the Team
Participants, within the prescribed period.
This form is to be returned NO LATER THAN 26 May 2017 to the Organizing
Committee Via mail at [email protected] with a copy to
[email protected] and [email protected]