OFFICIAL ENTRY FORM
First Name
Date Of Birth
Age`on Race Day
Mailing Address
Home Phone
WELCOME
AND
THANK YOU FOR YOUR REGISTRATION
Event Name
Sex
Last Name
Mobile Phone
Email Address
Military Service or Swimming Organization? (Name
Swimming Experience: Completion is required for entry.
Have you competed in ocean swimming before?
If Yes, include the following information:
Name of Event
Date
Location of Event
Number of Event (s)
* If No, You may only register for 800m swim.
How many days a week do you practice?
How far do you swim at each practice? __________meters
1500 Meter Freestyle Time________
Have you prepared for swimming this event?
Do you have Medical Insurance?
Have you read the rules and requirements for entry?
Do you understand?
Indicate the course you wish to swim
Please read waiver below
By submitting this form I agree and confirm to all information listed above.
Additional Comments
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