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

AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBolivia (Plurinational State of)Bosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos (Keeling) IslandsColombiaComorosCongoCongo (Democratic Republic of the)Cook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Kingdom of)EthiopiaFalkland Islands (Malvinas)Faroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHondurasHong KongHungaryIcelandIndiaIndonesiaIran (Islamic Republic of)IraqIreland (Republic of)Isle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea (Democratic People's Republic of)Korea (Republic of)KosovoKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesia (Federated States of)Moldova (Republic of)MonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth Macedonia (Republic of)Northern Mariana IslandsNorwayOmanPakistanPalauPalestine (State of)PanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint Martin (French part)Saint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint Maarten (Dutch part)SlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyrian Arab RepublicTaiwan, Province of ChinaTajikistanTanzania (United Republic of)ThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUgandaUkraineUnited Arab EmiratesUnited Kingdom of Great Britain and Northern IrelandUnited States Minor Outlying IslandsUnited States of AmericaUruguayUzbekistanVanuatuVatican City StateVenezuela (Bolivarian Republic of)VietnamVirgin Islands (British)Virgin Islands (U.S.)Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland IslandsCountry

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

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