Registration - London Silver Dolphins

Registration - Personal Information and Swim Events
Events - Long Course
(maximum of 6 events per swimmer)
Personal Information
Event #1 – 200m Open
specify stoke:
Event #2 - 50m Free
Last Name
First Name
Address
City
Province/State
Postal/Zip Code
Home Telephone
Work Telephone
E-Mail
Masters Registration #
Club Name
Age as of Dec. 31, 2013
Sex
Birth date (d/m/y)
Event #3 - 50m Breast
Event #4 - 100m Fly
Event #5 - 100m Back
Event #6 – 400m Open
specify stoke:
Event #7 - 50m Fly
Event #8 - 50m Back
Payment Summary:
Early Bird (by June 13)
Late Entry (after June 13)
$36.00
$40.00
Event #9 - 100m Free
Event #10 - 100m Breast
Total Amount Enclosed:
$
Event #11 – 800 Free**
**Time Permitting
Maximum of 6 events per swimmer.
Deck Entry fee: $50.00 Flat Fee, entries at the discretion of the Meet Manager
All payments must be made by cheque payable to: London Aquatic Club.
No refunds after July 2, 2013.
All entries must be accompanied by payment and sent to:
Paul Cappa, Meet Manager
Sunset Outdoor Swim Meet
828 Headley Drive
London, Ontario
N6H 3V8
Notes
1. Please provide entry times with your registration.
2. Heats will be swum slowest to fastest.
3. Age groups for individual events are: 18-24, 25-29, 30-34, 35-39, etc.
4. Registrations must include Masters Registration # and birth date to be accepted.
5. Awards will be ribbons for 1st, 2nd and 3rd in each age group.
6. To convert short course times to long course times, multiply short course times by 1.03.
Entry time (LC)
00:00.00