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Event registration
Event Timings: Registration from 1pm | Event starts at 2pm with first jump/splash
Event Address: The Crescent, Portstewart, BT55
Contact us at:
duckdiveportstewart@gmail.com
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* Indicates required question
Full name
*
Your answer
Email Address*
*
Your answer
Telephone Number
*
Your answer
Individual/Organisation/Business Name (If different from above)
*
Your answer
How many people would you like to enter?
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1 person
2 persons
3 persons
4 persons
Other:
Required
What age(s) are those entering the pool?
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5-10yrs
11-14yrs
15-17yrs
18-25yrs
25-30yrs
31-40yrs
41-40yrs
50+
Other:
I understand that I am required to present my sponsorship sheet with information and donation money raised in order to take part in this event. This must be handed to the event treasurer during registration.
*
Yes
Other:
Required
I confirm that I do not have any medical condition that may pose a risk to my health and/or safety by taking part in this event.
*
Yes
No
Other:
Required
Do you have a disability or require any assistance that we need to know about in order for you to take part in the Duck Dive event safely?
*
Your answer
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