London Region Championships 2020
This entry form should only be used by Enfield Swim Squad members.

PAYMENT FOR GALA ENTRIES WILL BE TAKEN BY DIRECT DEBIT. IF YOU HAVE NOT YET SIGNED UP FOR THE ESS GALA DIRECT DEBIT SCHEME, PLEASE DO SO HERE: https://pay.gocardless.com/AL0000NJ5PHFXB.
Email address *
Swimmer's surname *
Please enter SURNAME as registered with Swim England.
Your answer
Swimmer's FIRST name *
Please enter FIRST name as registered with Swim England.
Your answer
Date of Birth *
MM
/
DD
/
YYYY
Gender *
Swim England Registration Number *
Go to www.swimmingresults.org/biogs to find your number and check your time. If you do not know your Swim England number, please enter '00000'.
Your answer
Contact Mobile Number *
Your answer
50m Free
If you wish to enter this event, please enter your time in the following format: MM:SS.HH (e.g. 05:23.09; where minutes are 0, enter '00' for MM, e.g. 00:31.65). If you do NOT wish to enter this event, please leave blank.
Your answer
50 Free
Please confirm whether the entered time has been achieved in a 25-metre Short Course (SCM) or in a 50-metre Long Course (LCM) pool.
100m Free
If you wish to enter this event, please enter your time in the following format: MM:SS.HH (e.g. 05:23.09; where minutes are 0, enter '00' for MM, e.g. 00:31.65). If you do NOT wish to enter this event, please leave blank.
Your answer
100 Free
Please confirm whether the entered time has been achieved in a 25-metre Short Course (SCM) or in a 50-metre Long Course (LCM) pool.
200m Free
If you wish to enter this event, please enter your time in the following format: MM:SS.HH (e.g. 05:23.09; where minutes are 0, enter '00' for MM, e.g. 00:31.65). If you do NOT wish to enter this event, please leave blank.
Your answer
200 Free
Please confirm whether the entered time has been achieved in a 25-metre Short Course (SCM) or in a 50-metre Long Course (LCM) pool.
400m Free
If you wish to enter this event, please enter your time in the following format: MM:SS.HH (e.g. 05:23.09; where minutes are 0, enter '00' for MM, e.g. 00:31.65). If you do NOT wish to enter this event, please leave blank.
Your answer
400 Free
Please confirm whether the entered time has been achieved in a 25-metre Short Course (SCM) or in a 50-metre Long Course (LCM) pool.
50m Back
If you wish to enter this event, please enter your time in the following format: MM:SS.HH (e.g. 05:23.09; where minutes are 0, enter '00' for MM, e.g. 00:31.65). If you do NOT wish to enter this event, please leave blank.
Your answer
50 Back
Please confirm whether the entered time has been achieved in a 25-metre Short Course (SCM) or in a 50-metre Long Course (LCM) pool.
100m Back
If you wish to enter this event, please enter your time in the following format: MM:SS.HH (e.g. 05:23.09; where minutes are 0, enter '00' for MM, e.g. 00:31.65). If you do NOT wish to enter this event, please leave blank.
Your answer
100 Back
Please confirm whether the entered time has been achieved in a 25-metre Short Course (SCM) or in a 50-metre Long Course (LCM) pool.
200m Back
If you wish to enter this event, please enter your time in the following format: MM:SS.HH (e.g. 05:23.09; where minutes are 0, enter '00' for MM, e.g. 00:31.65). If you do NOT wish to enter this event, please leave blank.
Your answer
200 Back
Please confirm whether the entered time has been achieved in a 25-metre Short Course (SCM) or in a 50-metre Long Course (LCM) pool.
50m Breast
If you wish to enter this event, please enter your time in the following format: MM:SS.HH (e.g. 05:23.09; where minutes are 0, enter '00' for MM, e.g. 00:31.65). If you do NOT wish to enter this event, please leave blank.
Your answer
50m Breast
Please confirm whether the entered time has been achieved in a 25-metre Short Course (SCM) or in a 50-metre Long Course (LCM) pool.
100m Breast
If you wish to enter this event, please enter your time in the following format: MM:SS.HH (e.g. 05:23.09; where minutes are 0, enter '00' for MM, e.g. 00:31.65). If you do NOT wish to enter this event, please leave blank.
Your answer
100m Breast
Please confirm whether the entered time has been achieved in a 25-metre Short Course (SCM) or in a 50-metre Long Course (LCM) pool.
200m Breast
If you wish to enter this event, please enter your time in the following format: MM:SS.HH (e.g. 05:23.09; where minutes are 0, enter '00' for MM, e.g. 00:31.65). If you do NOT wish to enter this event, please leave blank.
Your answer
200m Breast
Please confirm whether the entered time has been achieved in a 25-metre Short Course (SCM) or in a 50-metre Long Course (LCM) pool.
50m Fly
If you wish to enter this event, please enter your time in the following format: MM:SS.HH (e.g. 05:23.09; where minutes are 0, enter '00' for MM, e.g. 00:31.65). If you do NOT wish to enter this event, please leave blank.
Your answer
50m Fly
Please confirm whether the entered time has been achieved in a 25-metre Short Course (SCM) or in a 50-metre Long Course (LCM) pool.
100m Fly
If you wish to enter this event, please enter your time in the following format: MM:SS.HH (e.g. 05:23.09; where minutes are 0, enter '00' for MM, e.g. 00:31.65). If you do NOT wish to enter this event, please leave blank.
Your answer
100m Fly
Please confirm whether the entered time has been achieved in a 25-metre Short Course (SCM) or in a 50-metre Long Course (LCM) pool.
200m Fly
If you wish to enter this event, please enter your time in the following format: MM:SS.HH (e.g. 05:23.09; where minutes are 0, enter '00' for MM, e.g. 00:31.65). If you do NOT wish to enter this event, please leave blank.
Your answer
200m Fly
Please confirm whether the entered time has been achieved in a 25-metre Short Course (SCM) or in a 50-metre Long Course (LCM) pool.
200m IM
If you wish to enter this event, please enter your time in the following format: MM:SS.HH (e.g. 05:23.09; where minutes are 0, enter '00' for MM, e.g. 00:31.65). If you do NOT wish to enter this event, please leave blank.
Your answer
200m IM
Please confirm whether the entered time has been achieved in a 25-metre Short Course (SCM) or in a 50-metre Long Course (LCM) pool.
400m IM
If you wish to enter this event, please enter your time in the following format: MM:SS.HH (e.g. 05:23.09; where minutes are 0, enter '00' for MM, e.g. 00:31.65). If you do NOT wish to enter this event, please leave blank.
Your answer
400m IM
Please confirm whether the entered time has been achieved in a 25-metre Short Course (SCM) or in a 50-metre Long Course (LCM) pool.
800m Free
If you wish to enter this event, please enter your time in the following format: MM:SS.HH (e.g. 05:23.09; where minutes are 0, enter '00' for MM, e.g. 00:31.65). If you do NOT wish to enter this event, please leave blank.
Your answer
800m Free
Please confirm whether the entered time has been achieved in a 25-metre Short Course (SCM) or in a 50-metre Long Course (LCM) pool.
1500m Free
If you wish to enter this event, please enter your time in the following format: MM:SS.HH (e.g. 05:23.09; where minutes are 0, enter '00' for MM, e.g. 00:31.65). If you do NOT wish to enter this event, please leave blank.
Your answer
1500m Free
Please confirm whether the entered time has been achieved in a 25-metre Short Course (SCM) or in a 50-metre Long Course (LCM) pool.
Name of your squad: *
I CERTIFY THAT ALL TIMES AND DATA ARE ACCURATE AT TIME OF SUBMISSION. I AUTHORISE ESS TO COLLECT THE RELEVANT EVENT ENTRY FEES VIA DIRECT DEBIT. *
Please see gala conditions for detail of entry fees. ESS will charge an additional £1 per swimmer to cover admin cost. IF YOU HAVE NOT YET SIGNED UP FOR THE ESS GALA DIRECT DEBIT SCHEME, PLEASE DO SO HERE: https://pay.gocardless.com/AL0000NJ5PHFXB.
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