Exmouth Leisure Centre Swimming Gala April 2026

Exmouth Leisure Centre Swimming Gala April 2026
Swimmer's Name*

First NameLast Name
Date of Birth*

DayMonthYear
Date
Email*
example@example.com
Contact Number*
Order of Events:

1. 100m Freestyle

2. 50m Breaststroke

3. 100m Backstroke

4. 50m Butterfly

5. 100m Breaststroke

6. 50m Backstroke

7. 100m Butterfly

8. 50m Freestyle
Events to Enter
50m Butterfly
Previous Time (optional)
50m Backstroke
Previous Time (optional)
50m Breaststroke
Previous Time (optional)
50m Freestyle
Previous Time (optional)
100m Butterfly
Previous Time (optional)
100m Backstroke
Previous Time (optional)
100m Breaststroke
Previous Time (optional)
100m Freestyle
Previous Time (optional)
Total Number of Events
Total Cost (£3.50 per event)

Payment Amount*

GBP

Payment Details
First Name	Last Name
Credit Card Number	Security Code
Card Expiration

Should be Empty: