ࡱ> >@78?#` 'bjbjmm ts $(((Pxl """"""$Wh8FF[888 8 888 0P( 8dq0888,8FFJdedlcdl  The RLSS UK Speed Championships 2010 ENTRY FORMS Male / Female **Open Only (15+) TEAM EVENTS ** Delete as appropriate All competitors must be in current membership of the RLSS UK on the closing date of 21/12/09 and on the day/s of the competition Please list all competitors details below state number of teams entering each event notify Organiser in writing on the day the names of competitors in each team Entry time must be submitted in appropriate box. Any entry without an entry time will not be included in the programme. Entry Fee 16 per team, per event Team Competitors from: Surname 1st NameDate of BirthRLSS UK Society No.4x50m Obstacle Relay No. of Teams4x25m Manikin Relay No. of TeamsMedley Relay No of TeamsLine Throw Relay No of TeamsCost of Events EnteredRLSS UK only Evidence of competency receivedExample - Smith Jones Carter Carter EtcJoe Fred Richard Chris14.07.1973 18.6.1993 02.05.82 30.08.7933333333 33333334 33333335 333333362 Teams Team A 1.52.00 Tea,m B 1.53.002 teams Team A 1.30.00 Team B 1.31.00None1 Team Team A 1.45.0048Coach name of each competitor1  Coach name2 Coach name3 Coach name4 Coach name5Coach name6Coach name7Coach name8Coach name9Coach name10Coach name11Coach name12Coach nameTOTAL AMOUNT OF ENTRIES  Members of a team must belong to the same Registered RLSS UK Affiliated Group/ATC. An ATC does not count as an 'Affiliated Group' unless it has paid separate membership in the appropriate category. I understand that, dependent on number of entries, some events may be held in the 25m pool. This will be at the discretion of the Organiser. Contact Name . Daytime Telephone No. Email address: Registered RLSS UK Affiliated Club/ATC Name/Society No. .. Expiry Date The RLSS UK Speed Championships 2010 ENTRY FORMS Male / Female **15/17 years only TEAM EVENTS ** Delete as appropriate All competitors must be in current membership of the RLSS UK on the closing date of 21/12/09 and on the day/s of the competition Please list all competitors details below state number of teams entering each event notify Organiser in writing on the day the names of competitors in each team Entry time must be submitted in appropriate box. Any entry without an entry time will not be included in the programme. Entry Fee 16 per team, per event Team Competitors from: Surname 1st NameDate of BirthRLSS UK Society No.4x50m Obstacle Relay No. of Teams4x25m Manikin Relay No. of TeamsMedley Relay No of TeamsLine Throw Relay No of TeamsCost of Events EnteredRLSS UK only Evidence of competency receivedExample - Smith Jones Carter Carter EtcJoe Fred Richard Chris14.07.19?? 18.6.19?? 02.05.19?? 30.08.19??33333333 33333334 33333335 333333362 Teams Team A 1.52.00 Tea,m B 1.53.002 teams Team A 1.30.00 Team B 1.31.00None1 Team Team A 1.45.0048Coach name of each competitor1  Coach name2 Coach name3 Coach name4 Coach name5Coach name6Coach name7Coach name8Coach name9Coach name10Coach name11Coach name12Coach nameTOTAL AMOUNT OF ENTRIES  Members of a team must belong to the same Registered RLSS UK Affiliated Group/ATC. An ATC does not count as an 'Affiliated Group' unless it has paid separate membership in the appropriate category. I understand that, dependent on number of entries, some events may be held in the 25m pool. This will be at the discretion of the Organiser. Contact Name . Daytime Telephone No. Email address: Registered RLSS UK Affiliated Club/ATC Name/Society No. .. Expiry Date The RLSS UK Speed Championships 2010 ENTRY FORMS Male /Female 12/14 years Only ** TEAM EVENTS ** Delete as appropriate All competitors must be in current membership of the RLSS UK on the closing date of 21/12/09 and on the day/s of the competition Please list all competitors details below state number of teams entering each event notify Organiser in writing on the day the names of competitors in each team Entry time must be submitted in appropriate box. Any entry without an entry time will not be included in the programme. Entry Fee 16 per team, per event Team Competitors from: Surname 1st NameDate of BirthRLSS UK Society No.4x50m Obstacle Relay No. of Teams4x25m Manikin Relay No. of TeamsMedley Relay No of TeamsLine Throw Relay No of TeamsCost of Events EnteredRLSS UK only Evidence of competency receivedExample - Smith Jones Carter Carter EtcJoe Fred Richard Chris14.07.19?? 18.6.19?? 02.05.19?? 30.08.19??33333333 33333334 33333335 333333362 teams Team A 1.30.00 Team B 1.31.002 teams Team A 1.30.00 Team B 1.31.00None1 Team Team A 1.45.0048Coach name of each competitor1  Coach name2 Coach name3 Coach name4 Coach name5Coach name6Coach name7Coach name8Coach name9Coach name10Coach name11Coach name12Coach nameTOTAL AMOUNT OF ENTRIES  Members of a team must belong to the same Registered RLSS UK Affiliated Group/ATC. An ATC does not count as an 'Affiliated Group' unless it has paid separate membership in the appropriate category. I understand that, dependent on number of entries, some events may be held in the 25m pool. This will be at the discretion of the Organiser. Contact Name . Daytime Telephone No. Email address: Registered RLSS UK Affiliated Club/ATC Name/Society No. .. Expiry Date The RLSS UK Speed Championships 2010 ENTRY FORMS Masters Male / Female ** Only TEAM EVENTS ** Delete as appropriate PLEASE INDICATE TOTAL AGE CATEGORY 120+ / 140+; / 170+ / 200+ ** (Minimum age of each competitor is 30 years) All competitors must be in current membership of the RLSS UK on the closing date of 21/12/09 and on the day/s of the competition Please list all competitors details below state number of teams entering each event notify Organiser in writing on the day the names of competitors in each team Entry time must be submitted in appropriate box. Any entry without an entry time will not be included in the programme. Entry Fee 16 per team, per event Surname1st NameDate of BirthRLSS UK Society No.4x50m Obstacle relayLine Throw RelayCost of Events EnteredRLSS UK only Evidence of competency receivedExample -Smith Jones Carter Carter EtcJoe Fred Richard Chris14.07.0000 18.6.0000 02.05.0000 30.08.000033333333 33333334 33333335 333333361 team 120+1 team 160+32Coach name of each competitor1Coach name2Coach name3Coach name4Coach name5Coach name6Coach name7Coach name8Coach name9Coach name10Coach name11Coach name12Coach nameTOTAL AMOUNT OF ENTRIES Members of a team must belong to the same Registered RLSS UK Affiliated Group/ATC. An ATC does not count as an 'Affiliated Group' unless it has paid separate membership in the appropriate category. I understand that, dependent on number of entries, some events may be held in the 25m pool. This will be at the discretion of the Organiser. Contact Name . Daytime Telephone No. Email address: Registered RLSS UK Affiliated Club/ATC Name/Society No. .. 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