2010 Shipwreck Coast Swim Series

Online Entry Form

First Name:
Surname:
Sex: Male Female
Date of birth:
Address:
Town:      State:    Postcode:
Email:
Please select the swims you wish to participate in:
PORT FAIRY - MOYNEYANA OCEAN SWIM entries closed
PORT CAMPBELL - TWELVE APOSTLES PLUNGE entries closed
WARRNAMBOOL - TONY RYAN MEMORIAL SWIM entries closed
I have read and understood the conditions of entry and hereby agree to all terms.
If you are under 18 years old please complete the following:
  Parent's or guardian's full name:
  Their contact number:


Swim Series Sponsors

Major Sponsor
Woodside



Silver Sponsor
R&D
Richardson and Dennis
Insurance Agents