Non-competitive,fun swimming gala

At Pershore Leisure Centre on Saturday 13th January 2018(5pm to 7pm)

The gala is non-competitive and open to any swimmer of any age or ability. Enter the event(s) you want, plus an estimated time. We will place you in a race with similar speed swimmers. All races are timed and recorded so you can beat it at the next gala! All proceeds go to St Richard’s Hospice

Family relay - only 2 swimmers required, each swimming 50m, but they must be related.

Individual Entry Form

Name:______Gender (M/F): ______

Age if under 18:______

Telephone: ______Email: ______

Event / Estimate time (min:sec) / Event / Estimate time (min:sec)
25m Freestyle / 50m Breaststroke
25m Backstroke / 100m Freestyle
25m Butterfly / 100m Butterfly
25m Breaststroke / 100m Breaststroke
50m Freestyle / 200m Freestyle
50m Backstroke / 100m Individual medley
50m Butterfly / Family relay 2 x 50m Free

Name of partner for family relay (if entered):______

Cost is £2 per person per race or £8 to enter as many races as you like. Payment can be made on the day.

Fee payable ______Please make cheques payable to Mr Chris Gooderham

Signed:______Date: ______

Declaration: I declare the above particulars to be correct. I certify that to the best of my knowledge I am physically fit and able to compete. I therefore exonerate the organisers from any injury as a result of my medical condition. I also confirm that I will only choose to start a race with an entry dive if I am proficient in the execution of them.

Entries to:

Mr Chris GooderhamClosing date for entries:

25 Ryelands, Wyre PiddleTuesday 9th January 2018

Pershore, Worcs. WR10 2JG

Email:

Tel: 01386 561355

Non-competitive, fun swimming gala

At Pershore Leisure Centre on Saturday 13th January 2018(5pm to 7pm)

The gala is non-competitive and open to any swimmer of any age or ability. Enter the event(s) you want, plus an estimated time. We will place you in a race with similar speed swimmers. All races are timed and recorded so you can beat it at the next gala! All proceeds go to St Richard’s Hospice

Family relay - only 2 swimmers required, each swimming 50m, but they must be related.

Individual Entry Form

Name:______Gender (M/F): ______

Age if under 18:______

Telephone: ______Email: ______

Event / Estimate time (min:sec) / Event / Estimate time (min:sec)
25m Freestyle / 50m Breaststroke
25m Backstroke / 100m Freestyle
25m Butterfly / 100m Butterfly
25m Breaststroke / 100m Breaststroke
50m Freestyle / 200m Freestyle
50m Backstroke / 100m Individual medley
50m Butterfly / Family relay 2 x 50m Free

Name of partner for family relay (if entered):______

Cost is £2 per person per race or £8 to enter as many races as you like. Payment can be made on the day.

Fee payable ______Please make cheques payable to Mr Chris Gooderham

Signed:______Date: ______

Declaration: I declare the above particulars to be correct. I certify that to the best of my knowledge I am physically fit and able to compete. I therefore exonerate the organisers from any injury as a result of my medical condition. I also confirm that I will only choose to start a race with an entry dive if I am proficient in the execution of them.

Entries to:

Mr Chris GooderhamClosing date for entries:

25 Ryelands, Wyre PiddleTuesday 9th January 2018

Pershore, Worcs. WR10 2JG

Email:

Tel: 01386 561355