New Club T-Shirt

First Name *

Last Name *

Select House/Section *

Please type swimming club *

Address *

Address line 2

City *

Post Code *

Phone / Mobile no *

email *

Please select Collection Point *

Collect House Head Coaches

Please specify Coach Name to pick up kit from *

Indicate number of each size(s) required

	Child 8/9y
	Child 10/11y
	Child 12/13y
	Child 14/15y
	Adult Small
	Adult Medium
	Adult Large
	Adult Extra Large

PayPal admin charge *

3.4% + 20p

Running Total: 🛈

£0.00