Registration

Register to participate in our Winter KM Challenge and raise funds for the club.

All proceeds will support club initiatives such as guest speakers and educational seminars.

Swimmer Information

First Name *

Last Name *

Date of Birth *

Swimming Squad *

Parent/Guardian Contact Email *

Total Distance Goal (km)

Sponsors

Sponsor 1

Sponsor Name *

Sponsor Email

Sponsor Phone

Pledge Type *

Per kilometre Fixed amount

Amount per kilometre *

$

Example: enter `2` for a pledge of $2 per kilometre swum.

I consent to club media/photos being used for challenge promotion.