One Hour Challenge Bulk Individual Entry

Club Organiser's Name *

First

Last

Club Name

Club Address *

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Club Email Contact Address *

Club Contact Phone number

UK Entries *

Total number of swimmers entered on the attached form *

Total cost for entries made (swimmer x £5.50) *

Number of swimmers X £5.50

File Upload *

Click or drag a file to this area to upload.

THIS MUST BE THE SUPPLIED BLDSA ONE HOUR CHALLENGE SPREADSHEET IN ORIGINAL FORMAT ANY ADDITIONAL FORMATTING WILL RESULT IN EXPORT FAILURE

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

Stripe Credit Card *

Card

Name on Card

Total to be paid

£ 0.00

Phone