Inscripciones / Registration
Reglamento - Inscripciones - Viajes - Programa - Resultados - Fotos - Home


                                                      XV MOM. MALLORCA OPEN MASTERS    18-19 April 2009

                                                                                                  RELAYS ENTRY  FORM

CLUB ________________________________________________Club register number________________________
Adress __________________________________________________________________________________________
City__________________________________  Country___________________zip code_________________________
Telef,______________________________Fax_____________________e-mail________________________________
Contact person___________________________________________________________________________________

Categorie 4x50 m free   4x50 medley   4x50 Mixed TOTAL
  Men Women Men Women Free Medley  
  Heat 11 Heat 12 Heat 24 Heat 25 Heat 13 Heat 26 Relays
PRE-MA 80-89              
  1      100-119              
  2      120-159              
  3      160-199              
  4      200-239              
  5      240-279              
  6      more 280              



TOTAL RELAY TEAMS ______________Entry Fees______ x  7  euros    =   ______________

(please indicate the time for each relay

Please, print de file, fill it and send it per fax to the Balearic Swim Federation  +971-764630