Before completing this team entry form please take a look at the Team List page to see which lanes are free

Fields marked with a ** are required. If you miss these out, validation will not let you proceed to submit.

1. 
   * * Choose one of the following days: (Fri 5 Feb 2010, Sat 6 Feb 2010 or Sun 7 Feb 2010)
   Select a Day Fri 5 Feb 2010 Sat 6 Feb 2010 Sun 7 Feb 2010
   
2. 
   * * Choose one of the following times:  (Fri 1630 to 2030, Sat 0830 to 2030 or Sun 0830 to 1530)
   Select Swim Time 0830 0930 1030 1130 1230 1330 1430 1530 1630 1730 1830 1930 2030
   
3. 
   * * Choose one of the following Lanes: (Lane 1 to Lane 8)
   Select a Lane Lane 1 Lane 2 Lane 3 Lane 4 Lane 5 Lane 6 Lane 7 Lane 8
   
4. 
   **  Enter your Team Name in the space provided below. ( A Trophy for the best Team Name)
   
   
5. 
   Please provide the following contact information:  (Our Data Protection statement is on this web site)

   ** Team Captain Name
   **Title	Select a Title Mr Mrs Ms Master Miss
   Organization
   ** Address1
   ** Address2
   Address3
   Address4
   ** Postal Code
   Work Phone	Code Number Ext
   ** Home Phone	Code Number
   E-mail

   
   
6. Enter any other information below: