Liverpool Spring Open Meet 2017 (SWIMMERS WITH DISABILITIES ENTRY FORM ONLY) Name Club Closing Date For of Contact Entries Swim Email Noon Friday 3rd Club Address March 2017 Swimmer Swimmer 1 First Name(s) Surname Sex: Male / Female Date of Birth / / ASA Number Disability Classification S: SM: Age @ 31/12/2017 Contact Number Email Address 50 200m Fr/s 200m I.M. 400m Fr/s Total Individual Entry Fees £ @ £7 each Appendix 4a Team Entry Form Girls –
Liverpool Spring Open Meet 2017 (SWIMMERS WITH DISABILITIES ENTRY FORM ONLY) Name of Swim Club Club Contact Email Address Closing Date For Entries Noon Friday 3rd March 2017 Swimmer Swimmer 1 First Name(s) Surname Sex: Male / Female Date of Birth / / ASA Number Disability Classification S: SM: Age @ 31/12/2017 Contact Number Email Address 50 200m Fr/s 200m I.M. 400m Fr/s Total Individual Entry Fees @ £7 each £ Appendix 4a – Team Entry Form Girls