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


                                                     MOM MALLORCA OPEN MASTERS "MOM"

                                                                                                  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     280-319
             
  7     320-359              



TOTAL RELAY TEAMS ______________Entry Fees______ x  9   euros    =   ______________

(please indicate the time for each relay

Please, print de file, fill it and send it per E-mail to the
Balearic Swim Federation fbn@fbnatacion.org ò Jordi Granados   granados.j@telefonica.net