National Masters Championships 2004
Ponds Forge Aquatics Centre
Sheffield
March 20th/21st 2004
Please complete the entry form and return to the address given below before the closing date, together with the entry fees shown.
Name:...........................................................................................................................
Club:.............................................................................................................................
Address:......................................................................................................................
.......................................................................................................................................
E-mail Address:.........................................................................................................
Telephone:........................................................ Date of Birth:...............................
	Male	q	Female	q

Open Age Group		Novice Age Group		Events Entered
16 - 24	q	16 - 29	q	Novice 1 Metre	q
25 - 29	q	30 - 49	q	Novice 3 Metre	q
30 - 39	q	50 - 69	q	Novice Highboard	q
40 - 49	q	70 +	q
50 - 59	q			Masters 1 Metre	q
60 - 69	q			Masters 3 Metre	q
70 - 79	q			Masters Highboard	q
80 +	q

Event Entry fees are £7.00 for the individual events. Non GBDF members will be charged a £5.00 Temporary membership to cover the duration of the events.

All cheques payable to GB Diving Federation. Late entries will pay £5.00 per event penalty.

Number of events entered .............. GBDF Member     Yes/No	Entry Fees enclosed    £ ............
( ) x Tee shirts   @ £10.00 = £............ Chest size ....... inches	( ) x Polo Shirts @ £15.00 = £............ Chest size ....... inches
Function Deposit @ £5.00 ........	Total Enclosed £.........

I confirm that there are no medical reasons why I cannot dive in the events above and confirm that I am capable of performing the dives required for the events I have entered in a safe manner. Signature of entrant:....................................................... Date:..................

No entries accepted without payment or signature!

Please send entries NO LATER than 1st March to:-

Mrs Lesley Grist

6 Derwent Avenue,

Wilsden, Bradford,

West Yorkshire,

BD15 0LY.

Telephone No 01535 273633