On-Line Registration for VFM Winter Classic Meet
Last Name
First Name
M.I.
Street Address
City
State
Zip Code
Phone Number
E-Mail Address
Birthdate
USMS Reg#
Club/Team
Event Number and Event Name
Event 1 500 Freestyle
Event 2 400 Individual Medley
Event 3 100 Individual Medley
Event 4 200 Butterfly
Event 5 50 Backstroke
Event 6 100 Breaststroke
Event 7 50 Freestyke
Event 8 200 Backstroke
Event 9 200 Individual Medley
Event 10 50 Butterfly
Event 11 200 Freestyle
Event 12 200 Breaststroke
Event 13 100 Backstroke
Event 14 100 Butterfly
Event 15 50 Breastroke
Event 16 100 Freestyle
Seed Time
Club/Team Name
Sex/Age
Event Number and Event Name
Event 1 500 Freestyle
Event 2 400 Individual Medley
Event 3 100 Individual Medley
Event 4 200 Butterfly
Event 5 50 Backstroke
Event 6 100 Breaststroke
Event 7 50 Freestyke
Event 8 200 Backstroke
Event 9 200 Individual Medley
Event 10 50 Butterfly
Event 11 200 Freestyle
Event 12 200 Breaststroke
Event 13 100 Backstroke
Event 14 100 Butterfly
Event 15 50 Breastroke
Event 16 100 Freestyle
Seed Time
Club/Team Name
Sex/Age
Event Number and Event Name
Event 1 500 Freestyle
Event 2 400 Individual Medley
Event 3 100 Individual Medley
Event 4 200 Butterfly
Event 5 50 Backstroke
Event 6 100 Breaststroke
Event 7 50 Freestyke
Event 8 200 Backstroke
Event 9 200 Individual Medley
Event 10 50 Butterfly
Event 11 200 Freestyle
Event 12 200 Breaststroke
Event 13 100 Backstroke
Event 14 100 Butterfly
Event 15 50 Breastroke
Event 16 100 Freestyle
Seed Time
Club/Team Name
Sex/Age
Event Number and Event Name
Event 1 500 Freestyle
Event 2 400 Individual Medley
Event 3 100 Individual Medley
Event 4 200 Butterfly
Event 5 50 Backstroke
Event 6 100 Breaststroke
Event 7 50 Freestyke
Event 8 200 Backstroke
Event 9 200 Individual Medley
Event 10 50 Butterfly
Event 11 200 Freestyle
Event 12 200 Breaststroke
Event 13 100 Backstroke
Event 14 100 Butterfly
Event 15 50 Breastroke
Event 16 100 Freestyle
Seed Time
Club/Team Name
Sex/Age
Event Number and Event Name
Event 1 500 Freestyle
Event 2 400 Individual Medley
Event 3 100 Individual Medley
Event 4 200 Butterfly
Event 5 50 Backstroke
Event 6 100 Breaststroke
Event 7 50 Freestyke
Event 8 200 Backstroke
Event 9 200 Individual Medley
Event 10 50 Butterfly
Event 11 200 Freestyle
Event 12 200 Breaststroke
Event 13 100 Backstroke
Event 14 100 Butterfly
Event 15 50 Breastroke
Event 16 100 Freestyle
Seed Time
Club/Team Name
Sex/Age
Number of Events
1
2
3
4
5
Events x $4.00
4.00
8.00
12.00
16.00
20.00
Surcharge
5.00
Total
9.00
13.00
17.00
21.00
25.00