First Name:   Last Name:

Sex: Sex Male Female       Birth Date: Day 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Month January February March April May June July August September October November Diciember Year 1910 1911 1912 1913 1914 1915 1916 1917 1918 1919 1920 1921 1922 1923 1924 1925 1926 1927 1928 1929 1930 1931 1932 1933 1934 1935 1936 1937 1938 1939 1940 1941 1942 1943 1944 1945 1946 1947 1948 1949 1950 1951 1952 1953 1954 1955 1956 1957 1958 1959 1960 1961 1962 1963 1964 1965 1966 1967 1968 1969 1970 1971 1972 1973 1974 1975 1976 1977 1978 1979 1980 1981 1982      Age:

Address:

City:          Country:       Zip Code:

Phone:                 E-Mail:

Club Name:

Choose the event and enter classifying time for the event you want to swim.  The organizing Committee must receive this registration form and registration fees before August 18, 2007.  Maximum of 5 individual events and not more than 2 per day.

                                                 Events                              Time                     Events                             Time

Friday, August  31 :            None 200 mts Combinado Ind. 200 mts Pecho 50 mts Dorso 100 mts Mariposa      None 200 mts Combinado Ind. 200 mts Pecho 50 mts Dorso 100 mts Mariposa   

Saturday, September 1 :     None 400 mts Combinado Ind. 200 mts Libre 50 mts Mariposa 100 mts Pecho      None 400 mts Combinado Ind. 200 mts Libre 50 mts Mariposa 100 mts Pecho   

Sunday, September 2:        None 400 mts Libre..................... 200 mts Dorso 100 mts Libre 50 mts Pecho      None 400 mts Libre..................... 200 mts Dorso 100 mts Libre 50 mts Pecho   

Monday, September 3:       None................................... 800 mts Libre 200 mts Mariposa 100 mts Dorso 50 mts Libre      None...................................... 800 mts Libre 200 Mts Mariposa 100 mts Dorso 50 mts Libre  

Press here to submit form          To continue with registration press here

 ***** If you have problems submitting the form send a e-mail to panammaster2007@asua-aquatics.org with your information.  *****