stripeform - Swim England Hertfordshire

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Date of birth*

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Your ASA registration number*

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East Region

Which Swim England region is your club affiliated to?*

If your club is in the Swim England East region please select your sub-region.

Select the event you want to enter from the list below*

Entry fee amount*

£15

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Tick the box to confirm that you have read and understood the conditions for these Championships.*

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Name of your club*