1. Healthcare

Gloucester Masters SC Open Meet
Sunday 19 April 2015
Closing date for entries: 14 March 2015
Individual Entry Form
Club
_____________________________
Gender
M/F_______
Name
________________________________
Date of Birth
____/_____/______
Address
Postcode____________
Tel_________________________
Email_______________________
ASA Reg. No.
_____________________________
Entry time
50m Free
100m Free
200m Free
400m Free
50m Back
100m Back
50m Breast
100m Breast
50m Fly
100m Fly
100m I.M.
400m I.M.
No. of entries___ @ £5.00 per event =___ (or £30 for 6+ entries) Total Fee.
Please make cheques payable to Gloucester Masters S.C., & complete declaration:
Declaration: I declare the above particulars to be correct and agree to abide by the conditions laid down by the promoting club for this competition.
I certify that to the best of my knowledge I am physically fit and able to compete and train in Masters Events and Training Sessions and have not
been advised otherwise by a Medical Advisor. I therefore exonerate ASA, GCASA, WCASA, Club, Officials and Meet Organisers from any injury
as a result of my medical condition. I also confirm that I am proficient in the execution, where necessary, of entry dives in accordance with ASA
recommendations.
Signed:
Completed entries to:
Date:
Mr Brian Jones
9 Bracken Close
Lydney, Glos GL15 5AH
Email: [email protected]
Closing date for entries:
14 March 2015
Gloucester Masters SC Open Meet
Sunday 19 April 2015
at
GL1 Gloucester Leisure Centre, Bruton Way, Gloucester
Deck level, 8 lane, 25m pool, 2m constant depth
5 year age bands plus Senior Age Group (18-24)
50/100m all strokes/ 100m I.M. & 400m I.M. / 200m & 400m F/S
Conditions & Programme
1. All events shall be held under ASA laws and technical rules as defined for masters’ events.
2. Ages for the Masters Events will be as at 31 December 2015. Competitors in the Senior Age
Group must have reached their 18th birthday by the day of the competition.
Closing date 14 March 2015
3. A competitor must be a member of the club he/she represents and may only swim for one
club during the competition.
4. Entries to be submitted on the official form accompanied by the appropriate fee to: Mr Brian
Jones, 9 Bracken Close, Lydney, Gloucester, GL15 5AH. (for queries e-mail:
[email protected]) For email entries with PC Banking –see below.
5. Entry cards will not be issued prior to the meet. A list of entries will be published on our
website after the closing date. (www.gloucestermasters.com)
6. All events will be seeded in time classification and decided on a heat declared winner basis.
7. The one start rule will be in operation in line with ASA technical rules.
8. Awards details will be on the programme.
9. The entry fee will be £5.00 per event (but stays at £30 for 6 or more events). No refunds or
changes will be accepted after the closing date for entries.
10. We reserve the right to make any changes necessary for the smooth running of the meet.
(eg. ** possible limit to entries in 400m. events )
Start 10.00
Event 1
Event 2
Event 3
Event 4
Event 5
Event 6
Event 7
Event 8
Event 9
Event 10
Warm-up: F 9.00, M 9.30
Mixed 400m f/s **
Ladies 50m fly
Mens 50m fly
Ladies 100m breast
Mens 100m breast
Ladies 50m back
Mens 50m back
Ladies 100m f/s
Mens 100m f/s
Mixed 400m I.M.
Lunch Break
Start 2pm
Event 11
Event 12
Event 13
Event 14
Event 15
Event 16
Event 17
Event 18
Event 19
Event 20
Event 21
Mixed warm-up 1.15 approx
Mixed 200m f/s
Ladies 100m I.M.
Mens 100m I.M.
Ladies 50m breast
Mens 50m breast
Ladies 100m back
Mens 100m back
Ladies 100m fly
Mens 100m fly
Ladies 50m f/s
Mens 50m f/s
Email entries and payment by PC banking.
The entry form can be completed using Adobe Reader – see below ( or simply
scanned and attached ) and then emailed to Brian Jones at:
[email protected]
Payment can be made by bank transfer to:
The co-operative bank
Account name: Gloucester Masters Swimming Club
Sort Code: 08 92 99
Account no: 6541 3933
Please give your surname/firstname as reference so that payments can be
identified and inform Brian that payment has been made in the emailed
entry.
Postal entries and payment by cheque to be sent to:
Mr Brian Jones, 9 Bracken Close, Lydney, Gloucester, GL15 5AH.
1. Save the document to your computer as a pdf.
2. Open saved document (should open in Adobe Reader)
3. Click on the 'Sign' tab at the top of the page - it opens an edit facility alongside the document.
4. Click on the 'Add Text' button in the edit section.
5. Click on the document where you want to add text and type.
6. To sign click on the 'Place Signature' button then edit text on document.
Save the document and attach to email.