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MULTI ENTRY FORM

EXCLUSIVELY FOR MAROUBRA SC MEMBERS
Swimmers from other clubs, please submit your entries to your Club's Race Secretary
First Name*
Last Name*
Swimming Club
MAROUBRA SWIMMING CLUB
Date of Birth*
Age*
Classification
Registration No.
Name of Meet*
Date of Meet*
Event no.* Stroke* Distance* Entry Time Achievement
Date/Place
Total  events *
Total entry fees* (Number of events  X  Entry fee per event)

$


PAYMENT INFORMATION
  • For direct deposit payments:
    • Account Name: Maroubra Swimming Club
      Bank: Westpac
      BSB: 032-134
      Account: 205235
    • email the online receipt to race@mbra.org.au 
  • Entries will only be finalised on receipt of full payment and all payment information. After paying by direct deposit please email race@mbra.org.au the direct deposit receipt number and swimmer's name.
  • Should payment proof not be received by email within 3 days of the close of entries date, the entry will be cancelled and an email notification sent to the entry contact.
Comments:
email*: