SWIMMING VICTORIA (METRO NORTH) ENTRY CARD

							                         MILL PARK SWIM CLUB
                              ENTRY CARD
                             To: Team Manager/Entry Box
                                     $3.50 per event
                        You will be invoiced with your term fees.




SWIM MEET: 2010 Club
                                        Date of Meet 2th May 2010
Championships
Last Name:                              First Name:
Club: Mill Park Swim Club               Date of Birth
                  Entries Close; 26th April 2010
    Event Number             Distance                   Stroke




       Number of Events                  Total Money Owed
                                   $

                             Declaration:
     I am currently a registered member of the club shown above
              (Registration runs from 1 May to 30 April).
           I am aware that the Entry Fee is not returnable.


     Signature:                            Phone: