TEAM INFORMATION CLUB NAME: INITIALS: ADDRESS: LSC: HEAD COACH: CONTACT PERSON: PHONE NUMBER: FAX NUMBER: CELL PHONE: EMAIL: NAME COACHES CARD EXPIRATION DATE 1. COACHES 2. ATTENDING: 3. 1. 2. CERTIFIED OFFICIALS WHO MAY 3. WISH TO WORK: 4. ATTACHED: NUMBER OF SWIMMERS ENTERED: UNATTACHED: TOTAL: SUMMARY OF FEES SES TEAMS X $3.00 SURCHARGE = NUMBER OF SWIMMERS: NON-SES TEAMS X $5.00 SURCHARGE = NUMBER OF SWIMMERS: NUMBER OF SWIMMERS: X $7.00 FACILITY SURCHARGE = NUMBER OF . EVENTS: X $6.00 EVENT ENTRY FEE = TOTAL DUE:
TEAM INFORMATION CLUB NAME: INITIALS: ADDRESS: LSC: HEAD COACH: CONTACT PERSON: PHONE NUMBER: FAX NUMBER: CELL PHONE: EMAIL: COACHES ATTENDING: NAME COACHES CARD EXPIRATION DATE 1. 2. 3. CERTIFIED OFFICIALS WHO MAY WISH TO WORK: 1. 2. 3. 4. NUMBER OF SWIMMERS ENTERED: ATTACHED: UNATTACHED: TOTAL: SUMMARY OF FEES SES TEAMS NUMBER OF SWIMMERS: X $3.00 SURCHARGE = NON-SES TEAMS NUMBER OF SWIMMERS: X $5.00 SURCHARGE = NUMBER OF SWIMMERS: X $7.00 FACILITY SURCHARGE = NUMBER OF . EVENTS: X $6.00 EVENT ENTRY FEE = TOTAL DUE: