Competition Entry Form
Kilkenny Swimming Club 2019/2020
Competition Name
*
Competition Entry Deadline
-
Day
-
Month
Year
5:30pm
Competition Date
/
Day
/
Month
Year
Date
Per Race Fee
Parent Mobile Phone Number
*
e.g. 0851234567
Parent Email
*
example@example.com
Accept email/ SMS in relation to this competition? (GDPR)
*
Accept
Do not accept
Back
Next
You must enter the details and races of at least one swimmer.
Full Name of First Swimmer
*
First name and surname required
Swim Ireland Membership Number (first swimmer)
*
available from kilkennyscmembershipsecretary@gmail.com
Date of Birth (first swimmer)
*
/
Day
/
Month
Year
Date
Freestyle (1st swimmer)
50m
100m
200m
Backstroke (1st swimmer)
50m
100m
200m
Breastroke (1st swimmer)
50m
100m
200m
Butterfly (1st swimmer)
50m
100m
200m
Individual Medley (1st swimmer)
200m
Add second family member to this competition
*
Yes
No
If 'Yes' is selected you will be taken to a page to enter the races for that swimmer. If you select 'No' you will be taken to the payment calculation page.
Back
Next
Full Name of Second Swimmer
*
First name and surname required
Swim Ireland Membership Number (second swimmer)
*
available from kilkennyscmembershipsecretary@gmail.com
Date of Birth (second swimmer)
*
/
Day
/
Month
Year
Date
Freestyle (2nd swimmer)
50m
100m
200m
Backstroke (2nd swimmer)
50m
100m
200m
Breastroke (2nd swimmer)
50m
100m
200m
Butterfly (2nd swimmer)
50m
100m
200m
Individual Medley (2nd swimmer)
200m
Add third family member to this competition
*
Yes
No
If 'Yes' is selected you will be taken to a page to enter the races for that swimmer
Back
Next
Full Name of Third Swimmer
*
First name and surname required
Swim Ireland Membership Number (third swimmer)
*
available from kilkennyscmembershipsecretary@gmail.com
Date of Birth (third swimmer)
*
/
Day
/
Month
Year
Date
Freestyle (3rd swimmer)
50m
100m
200m
Backstroke (3rd swimmer)
50m
100m
200m
Breastroke (3rd swimmer)
50m
100m
200m
Butterfly (3rd swimmer)
50m
100m
200m
Individual Medley (3rd swimmer)
200m
Add fourth family member to this competition
*
Yes
No
If 'Yes' is selected you will be taken to a page to enter the races for that swimmer
Back
Next
Full Name of Fourth Swimmer
*
First name and surname required
Swim Ireland Membership Number (fourth swimmer)
*
available from kilkennyscmembershipsecretary@gmail.com
Date of Birth (fourth swimmer)
*
/
Day
/
Month
Year
Date
Freestyle (4th swimmer)
50m
100m
200m
Backstroke (4th swimmer)
50m
100m
200m
Breastroke (4th swimmer)
50m
100m
200m
Butterfly (4th swimmer)
50m
100m
200m
Individual Medley (4th swimmer)
200m
Back
Next
Total number of races entered
*
From selections of previous page
Calculation of Entry Fees Due
*
(Number of races * per race fee)
Total Payment Due
*
prev
next
( X )
EUR
2019 NAC November Gala Invite (Level 3)
Submit
Clear Form
Print Form
Should be Empty: