MILO / NSC / PRAKL AGE GROUP SWIMMING CHAMPIONSHIP 2018 26th - 28th January, 2018 @ Kompleks Renang Kuala Lumpur, Bandar Tun Razak, Kuala Lumpur

IBSC's ENTRY FORM

NAME OF AFFILIATE :

Please circle

SUBMIT BEFORE 27 DEC, 2017 IKAN BILIS SWIMMING CLUB (IBSC)

EVENT

FREESTYLE

BREASTSTROKE

Gender

BOY / GIRL

Group

OPEN / 1 / 2 / 3 / 4 / 5

BACKSTROKE

IM

BUTTERFLY

EVENT NO. SWIMMER'S NAME

Date of Birth (DD/MM/YY)

50M

100M

200M @

400M 1500M Boys/ 800M Girls # Open #

50M

100M @

200M #

50M

100M @

200M #

50M

100M @

200M #

200M @

FEES RM

400M #

Individual Event Fees (RM8 x ______events) Registration Fee/ swimmer

13

transfer can be made to "KELAB RENANG IKAN BILIS", HONG LEONG BANK BERHAD, AC NO. 321-00000-386". By participating in the above swimming championship, the swimmer together with the parents/guardians agreed to be bound by the rules of the Club and will indemnify Ikan Bilis Swimming Club at all times and irrevocably discharge all its committee members, coaches and volunteers from any claim and responsibilities in the event of property damage/ loss, injury, or untoward incident arising therefrom.

Total Payable (RM) Swimmer's Signature : Parent's Signature :

Date: Cash / Giro / Cheque : Cheque No. ______________

Office's Use

IMPORTANT NOTES : 1 Only IBSC swimmers who have renewed their 2018 memberships are eligible for entry. Please submit 2018 membership renewal form together. 2 Use separate entry form for each swimmer. 3 Date of reckoning is 1 Jan, 2018 eg. Swimmer born in 2007 (2018-2007-1 = 10 years) would be in Group 4 for 10 & under. 4 Fill in the recent personal best time against the event to be entered and a "NT" if no time is available. There is no qualifying time. 5 Events marked # is not applicable to Group 4 & 5. Events marked @ is not applicable to Group 5. 6 Registration fee of RM35/- per swimmer is compulsory. 7 Entry Fee per individual event is RM8. 8 Entry Fee of RM32 per relay event will be borne by the Club. Relay swimmers will be decided by the Team Manager/coach. 9 Scratching of events are allowed later but no refund of event fee will be made. A penalty of RM25 is payable for unscratched event/NS/DNS. 10 Meals and snacks to registered swimmers will be provided by the Club for the 3 days competition. 11 Please return this completed form & payment to your respective coaches or submit to IBSC's office before 27 Dec, 2017. 12 Payment in cash or cheque to "KELAB RENANG IKAN BILIS" or staple your bank payment/giro slip to this form. Online internet banking

Date Received : Amount Received : Hy-Tek Entry :

RM

35.00