| Name of Meet
|
| Name of
Swimmer |
| Age of swimmer
on first day of meet
|
| Event # |
Distance
Stroke |
| Event # |
Distance
Stroke
|
| Event # |
Distance
Stroke
|
| Event # |
Distance
Stroke
|
| Event # |
Distance
Stroke
|
| Event # |
Distance
Stroke
|
| Event # |
Distance
Stroke
|
| Event # |
Distance
Stroke
|
| Event # |
Distance
Stroke
|
| Event # |
Distance
Stroke
|
| Event # |
Distance
Stroke
|
| Event # |
Distance
Stroke
|
| Event # |
Distance
Stroke
|
| Event # |
Distance
Stroke
|
| Number of Events x $ per event = |
| Additional Fee $ |
|
Total Amount Enclosed
$
Cash orCheck
#
|