County Championships 2016

NOTTINGHAMSHIREASA

COUNTY CHAMPIONSHIPS 2016

Entry Form

Swimmers Details:
Forename:
Surname:
Date of Birth: / ASA Number:
Email Address:
Gender: / Female
Event / Event Number / Session / Venue / Course / Date / Enter Event
50m Freestyle / Event / Session 15 / Harvey Hadden / Long / 14th Feb
100m Freestyle / Event / Session 3 / Harvey Hadden / Long / 17th Jan
200m Freestyle / Event / Session 3 / Harvey Hadden / Long / 17th Jan
400m Freestyle / Event / Session 12 / Harvey Hadden / Long / 13th Feb
800m Freestyle / Event / Session 2 / Harvey Hadden / Long / 16th Jan
50m Backstroke / Event / Session 6 / Water Meadows / Short / 6th Feb
100m Backstroke / Event / Session 15 / Harvey Hadden / Long / 14th Feb
200m Backstroke / Event 103 / Session 1 / Harvey Hadden / Long / 16th Jan
50m Breaststroke / Event / Session 7 / Water Meadows / Short / 6th Feb
100m Breaststroke / Event 101 / Session 1 / Harvey Hadden / Long / 16th Jan
200m Breaststroke / Event / Session 13 / Harvey Hadden / Long / 13th Feb
50m Butterfly / Event / Session 7 / Water Meadows / Short / 6th Feb
100m Butterfly / Event / Session 12 / Harvey Hadden / Long / 13th Feb
200m Butterfly / Event / Session 4 / Harvey Hadden / Long / 17th Jan
100m Individual Medley / Event / Session 6 / Water Meadows / Short / 6th Feb
200m Individual Medley / Event / Session 14 / Harvey Hadden / Long / 14th Feb
400m Individual Medley / Event / Session 5 / Harvey Hadden / Long / 17th Jan

Total number of entries submitted ...... x £4.00 per entry = £......

Entry forms must be submitted via your club

Individual entry forms are not accepted

Please return this form with payment to Alison or Amanda by 9pm on Wednesday 23rd December.

No entries will be accepted after this time

Entry Times are not needed on this form as all entry times must come from the National Rankings database, if you do not have a time for an event in the national rankings database you will not be able to enter the event. Please check the full schedule document and qualifying times document for full entry criteria.

Swimmers Details:
Forename:
Surname:
Date of Birth: / ASA Number:
Email Address:
Gender: / Male
Event / Event Number / Session / Venue / Course / Date / Enter Event
50m Freestyle / Event 606 / Session 15 / Harvey Hadden / Long / 14th Feb
100m Freestyle / Event 102 / Session 1 / Harvey Hadden / Long / 16th Jan
200m Freestyle / Event 215 / Session 4 / Harvey Hadden / Long / 17th Jan
400m Freestyle / Event 601 / Session 14 / Harvey Hadden / Long / 14th Feb
1500m Freestyle / Event 515 / Session 13 / Harvey Hadden / Long / 13th Feb
50m Backstroke / Event 309 / Session 7 / Water Meadows / Short / 6th Feb
100m Backstroke / Event 502 / Session 12 / Harvey Hadden / Long / 13th Feb
200m Backstroke / Event 217 / Session 5 / Harvey Hadden / Long / 17th Jan
50m Breaststroke / Event 303 / Session 6 / Water Meadows / Short / 6th Feb
100m Breaststroke / Event 201 / Session 3 / Harvey Hadden / Long / 17th Jan
200m Breaststroke / Event 504 / Session 12 / Harvey Hadden / Long / 13th Feb
50m Butterfly / Event 305 / Session 6 / Water Meadows / Short / 6th Feb
100m Butterfly / Event 604 / Session 15 / Harvey Hadden / Long / 14th Feb
200m Butterfly / Event 104 / Session 1 / Harvey Hadden / Long / 16th Jan
100m Individual Medley / Event 307 / Session 7 / Water Meadows / Short / 6th Feb
200m Individual Medley / Event 117 / Session 2 / Harvey Hadden / Long / 16th Jan
400m Individual Medley / Event 203 / Session 3 / Harvey Hadden / Long / 17th Jan

Total number of entries submitted ...... x £4.00 per entry = £......

Entry forms must be submitted via your club

Individual entry forms are not accepted

Please return this form with payment to Alison or Amanda by 9pm on Wednesday 23rd December.

No entries will be accepted after this time

Disability Swimmers Details:
Forename:
Surname:
Date of Birth: / ASA Number:
Email Address:
Gender: / Male / Female / Classification: / S SB SM

To enter these mixed multi-classification disability specific eventsdisabled swimmers do not necessarily need to be officially classifiedbut must be considered eligible by their club coach.

Swimmers must be members of a club and be ASA registered category 2.

Swimmers who are officially classified or on the classification waiting list may enter these events but are also eligible to enter the mainstream eventssubject to meeting the published able-bodied qualification times.

Event / Event Number / Session / Venue / Course / Date / Enter Event
50m Freestyle / Event 603 / Session 15 / Harvey Hadden / Long / 14th Feb
100m Freestyle / Event 105 / Session 2 / Harvey Hadden / Long / 16th Jan
50m Backstroke / Event 306 / Session 7 / Water Meadows / Short / 6th Feb
100m Backstroke / Event 608 / Session 16 / Harvey Hadden / Long / 14th Feb
50m Breaststroke / Event 301 / Session 6 / Water Meadows / Short / 6th Feb

Total number of entries submitted ...... x £4.00 per entry = £......

Entry forms must be submitted via your club

Individual entry forms are not accepted

Please return this form with payment to Alison or Amanda by 9pm on Wednesday 23rd December.

No entries will be accepted after this time

Team Event Details:
Club:
Team Name:
Team Gender: / Male / Female / Mixed
Point of Contact:
Email Address:

Each submitted time enters the Club team in that event in the Championships.

No entry can be accepted without a submitted time.

No swimmer may swim as a member of a team, having entered the individual events as a member of another club.

All event to be held On Sunday 7th February at Water Meadows

Event / Age Group / Entry Time
4 x 50m Freestyle Relay / 09 / 10
4 x 50m Freestyle Relay / 11 / 12
4 x 50m Freestyle Relay / 13 / 14
4 x 50m Freestyle Relay / 15 / 16
4 x 50m Freestyle Relay* / 17 / Over
4 x 100m Freestyle Relay^ / 17 / Over
4 x 50m Medley Relay / 09 / 10
4 x 50m Medley Relay / 11 / 12
4 x 50m Medley Relay / 13 / 14
4 x 50m Medley Relay / 15 / 16
4 x 50m Medley Relay* / 17 / Over
4 x 100m Medley Relay^ / 17 / Over

Total number of entries submitted ...... x £10.00 per entry = £......

Only A and B teams will be accepted per event.

Each team must have its own team manager.

There is a compulsory team managers meeting before the start of the relay gala that ALL team managers MUST attend. If a team manager does not attend the meeting then team will not be allowed to compete in the gala.

* The 4 x 50m event for the 17/Over age group is for Mixed Teams Only

^ The 4 x 100m event for the 17/Over age group is for Single Gender Teams Only