100M RELAY LEARN TO SWIM

Swimming At *Epworth Swimming Pool, PMBArboretum Swimming Pool, R/BayPick Your Swimming Event Location

Company details

School/Club Name *

Contact Name *

Email Address *

Phone *

100M RELAY LEARN TO SWIM:1. 100m Learn to Swim Relay teams must consist of 4 swimmers, mixed gender 2. Age group: 8 and under

Swimmer Name & Surname *

Date Of Birth *

Date of Swimmer birth

Gender *MaleFemale

MEDALS	All swimmers completing the relay

CategoryLEARN TO SWIM – 8 and Under ONLY Relay teams must be made of the 4 swimmers (Mixed gender) per relay:

Entry Fee *EFT R120.00

Total

R

PAYMENT INFORMATION:

Account Name:	Ushaka Aquatics
Bank:	Capitec
Account Number:	1052678319
Account Type:	Business Cheque
Branch Code:	450105
Swift Code:	CABLZAJJ
Reference:	Full Name or Team name
Proof of Payment:	Email to ushakasevents@gmail.com

For any additional information please contact the Event Manager:
Shirley Davidson: Cell 0767548948
Email: ushakasevents@gmail.com