CONSOLIDATED ENTRY FORM

Club_______________________________________________________

Person to who cards will be returned

Name__________________________Address_____________________________________________________ _______________________________________ Postcode ___________________ Phone ____________________

Email __________________________________

BOYS Name	Date of Birth	Freestyle	Backstroke	Breaststroke	Butterfly	Ind.Medley
GIRLS	Date of Birth	Freestyle	Backstroke	Breaststroke	Butterfly	Ind.Medley
Total entries

Money enclosed for ______ entries @ £3.50 __________ and 5 entries ________ @ £15.00 ___________

Coach’s passes ______ @ £10.00 __________Total _________ payable to Torquay Leander.