Worksop Dolphins Spring Open Meet 2015 License Level 3 - 3EM150629 Club: Given Name: Family Name: DOB : ASA Reg No : MALE / FEMALE : STROKE 50m TIME (25m) Freestyle : : : : : : : : : : : 100m Freestyle 200m Freestyle 400m Freestyle 100m Backstroke 200m Backstroke 100m Breaststroke 200m Breaststroke 100m Butterfly 200m Butterfly 200m Ind Medley : : : : : : : : : : : Address.................................................................................................... Phone........................................................Email...................................... Number of entries..................@ £5 =................. Add paper entry surcharge £1 Total ......................enclosed. If you are entering more than one swimmer please also complete the summary form Mrs Monica Wilkinson, 52 Riddell Avenue, Langold, Worksop, Notts S81 9PP Cheques payable to ‘Worksop Dolphins SC’ (To pay by BACS please email for the account details) CLOSING DATE – FRIDAY 10th APRIL 2015 or when full on a first come first served basis If you are a qualified official and would like to help please complete the volunteer officials form and return with your entries Email: [email protected] www.worksopdolphins.co.uk Worksop Dolphins Spring Open Meet 2015 License Level 3 - 3EM150629 Club or SS Entry Manager Summary Form Please complete this summary form and return it with payment to the gala administrator. (Entry acknowledgment is via the website) CLUB …………………………………………………………….. Date ………………………… Entry Coordinator………………………………………………. Tel No ………………………… Address …………………………………………………………. Post Code …………………… EMAIL …………………………………………………………………………………………………….. Swimmer’s Name (Individual events £5.00) Number of Events Fees Total Total swims @ £5 Coaches passes @£8 For paper entry forms add the surcharge of £1 per swimmer No of swimmers .............. @ £1 = Total Enclosed = If using SS Entry Manager please complete this form only. Individual entry forms are not required. DO NOT FORGET TO APPLY FOR YOUR COACHES’ PASS Cheques payable to ‘Worksop Dolphins SC’ (To pay by BACS please email for the account details) Email: [email protected] www.worksopdolphins.co.uk Worksop Dolphins Spring Open Meet 2015 License Level 3 - 3EM150629 COACHES POOLSIDE PASS APPLICATION FORM CLUB NAME ASA NUMBER DBS NUMBER HOME ADDRESS Please note: Poolside passes will only be issued to registered club coaches and must be applied for in advance, include the fee of £8 with your swimmers entries. Poolside space is limited so passes will be initially restricted to one per club unless there is a proven need otherwise. Please collect passes on the day from our door stewards. Send with payment to the Entry Administrator. Cheques payable to ‘Worksop Dolphins SC’ (To pay by BACS please email for the account details) Email: [email protected] www.worksopdolphins.co.uk Worksop Dolphins Spring Open Meet 2015 License Level 3 - 3EM150629 VOLUNTEER OFFICIALS This is a level 3 licensed meet so the requirement is for officials to be qualified, it is currently not necessary to be licensed. Benefits: Free admission and programme/start sheets Refreshments and buffet lunch. Travel allowance of 40p per mile, (reduced by half to 20p if accompanying a swimmer) Ring side view of the action. Complimentary bottle of wine, if you last the day. Lose weight without the expense of a sauna. Name:................................................................. ASA No:............................................................. Please tick: Qualified as:............J1...............J2/S.................Referee Licensed:..........Y............N WE DO NEED AND APPRECIATE YOUR HELP THANK YOU Email: [email protected] www.worksopdolphins.co.uk
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