Great Covid Swim Challenge Team entry form

“30 minute pool challenge in the face of covid 19”

Where there’s a will – there’s always a way

To enter the team event, all swimmers must be the same sex and have already entered the individual Great Covid Swim Challenge event. You can only enter one team event, ie individuals must not be in multiple teams. Please check you have observed this rule otherwise your team entry will not count and your entry fee will be forfeited". *

• I Confirm all team members have entered as individuals

Team Name *

Team Gender *

• Female
• Male

Team Nationality *

Club Name

Team Email Address *

Primary Contact Phone Number

Team Address *

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

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TEAM Age GroupUnder 10's10 - 11 years12 - 13 years14 - 15 years16 - 17 years18 - 19 years20 - 24 years25 years plus35 years plus45 years plus55 years plus65 years plus

Team Member 1 - Name *

First

Last

Team Member 1 - Age on 1st January 2021 *

Team Member 1 - Gender *MaleFemale

Team Member 1 - Disability *

• NONE
• H1
• H2
• H3

Team Member 1 - Swim Distance in Meters *

Team Member 2 - Name *

First

Last

Team Member 2 - Age on 1st January 2021 *

Team Member 2 - Gender *MaleFemale

Team Member 2 - Disability *

• NONE
• H1
• H2
• H3

Team Member 2 - Swim Distance in Meters *

Team Member 3 - Name *

First

Last

Team Member 3 - Age on 1st January 2021 *

Team Member 3 - Gender *MaleFemale

Team Member 3 - Disability *

• NONE
• H1
• H2
• H3

Team Member 3 - Swim Distance in Meters *

Total Team Distance Swam in 30 Mins - metres *

UK Entries *

• Team Entry

International Entries *

• Team Entry

By checking this box you agree to all the above data being stored under current GDPR guidelines *

• Accept GDPR rules

Total

£ 0.00

Stripe Credit Card *

Card

Name on Card

Email

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