Entry Form for Surrey Epee Championships.  If you are writing on a paper print then please write clearly.

1. First Name*  …………………………………

2. Surname*

3. Club?*

if "Other please state club:

                                                            (Out of area fencers see Surrey Fencing home page, under "Welcome").

4. Email: (please cut / paste from known working address to avoid errors):*
     if you do not have an email or chose not to enter one then please type  "none".  Email policy available on request.

6. Postal address (optional if you give an email and phone number.  We cannot guarentee data security).

Address line 1:  
Address line 2:
Address line 3:
Postcode:

7. Phone 1* (on the day number eg Mob.)

8. Phone 2  (optional)

9. BFA Membership Number:*  Expires:* If in post/progress then state so in box.

10. Year of birth (only if you are U18)
(Must be 13 or over on 1st Jan in season of event)

11. Seeding Information.  Please state your previous best results.  List best results first.  If this is your first competition then please state for how long you have been fencing.State any national ranking if applicable.
State Year, Event & weapon, Position/Rank




12. Competitors must ensure that all kit is of a safe and serviceable nature, and that BFA safety guidelines are met.

13. Signature (if U18 then signature of parent /guardian to be added to printed copy to accompany cheque)
I accept that the organisers cannot be held responsible for any accident, loss or damage sustained at the competition.
                Signature to be added on paper print out...keep reading!

Signed .....................………………………...........................……    date ............................................

13. If you have any message for the organiser then enter here:




Before pressing "submit" please print this page (May need page setup -> A4)

After printing out a paper copy to post then please press "SUBMIT" below.   This information will not be automatically collected unless you press submit.    If in doubt try again (so long as the name is the same we will cope!).

Don't forget to press "Submit" after printing this page (then post the print with your cheque)

14. Payment: Individual: Cheque for £14.00 payable “Surrey County Fencing Union”  
On the day payments accepted for this event but preferably submit this web form in advance.
           
15 Post the signed paper with your cheque to:
Tim Schofield, 3 OakTree Close, Guildford, Surrey, GU4 7JQ
If you need other contact details see website committee page.









This form was last updated: 18 September, 2011