Capital Swim Meet - 26 Jan 2019 - Entry Form
Hosted by DSW - Different Strokes Wellington Swim Club - Kilbirnie Pool
Warm-up from 1.30pm, Events start at 2.00pm
Part of the 2019 Rainbow Sport and Culture Weekend (25-27 Jan 2019)
Personal Information
First Name(s) *
Your answer
Surname *
Your answer
Address Line 1
Your answer
Address Line 2
Your answer
City/Town
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Email Address *
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Phone Number
Your answer
Gender *
DSW welcomes all participants to swim in events as the gender they most identify with
Date of Birth *
MM
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DD
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YYYY
Affiliation *
Emergency Contact: Name
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Emergency Contact: Phone Number
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Emergency Contact: Email Address
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ACC Disclaimer: (All swimmers must indicate their agreement to this disclaimer on registration.) The organising committee, officers, agents and members of DSW Swimming Club will not be responsible for any claims, proceedings or damage whatsoever arising directly or indirectly out of or in connection with its participation in this meet. *
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