Long Bridge Swim Registration Form

2.5 hour time limit for swim.

Registration Form
Long Bridge Swim, Aug. 1, 2009

Print this form and send to:
Long Bridge Swim
2023 Sandpoint West Dr.
Sandpoint, ID 83864

Online registration coming soon.

Early registration (Postmarked by June 14) - $16
Regular registration (Postmarked by July 5) - $20
Late registration - $25 (no guarantee of tee-shirt)
If no T-shirt is wanted subtract $5
You CAN register the day of the event! But if you want a t-shirt, please register by regular registration time.

Name: ________________________________________

E-mail address (we'll send you results)__________________________

Address: __________________________________________________________________

Phone: (____) ______________________Male ____Female ____Age as of 8-1-09 _____ _
Date of Birth _________

Fun and unusual information: (Swimming experience, teams/years, honors/accomplishments, obstacles overcome): __________________________________________________________________________________

__________________________________________________________________________________

Circle years you have participated in this swim 95 96 97 98 99 00 01 02 03 04 05 06 07 08

T-Shirts will be given out before event - please specify size: __ S __M __L __XL __XXL __XXXL
Youth __ S __M __L (XXL and XXXL $2 additional)

Additional T-shirts available for only $8, please indicate size & number. (XXL and XXXL $2 additional) $_____________

Total $_______________

Make checks payable to: Long Bridge Swim · 2023 Sandpoint West Dr., Sandpoint, ID 83864.

For more information, contact Jim Zuberbuhler at jzuberbuhler@earthlink.net, or Karen, by calling 208-265-2615 or emailing her.

Go to online registration.
Back to the Long Bridge Swim home page.
To the Long Bridge Swim rules and regulations.