Team Northern Ireland - Athlete Declaration

By completing this form you agree for your details to be passed onto the Northern Ireland Manager and RLSS UK. Your details will be used for communication on representing Northern Ireland at the Commonwealth Championships.

For more information about RLSS UK Privacy Policy please visit www.rlss.org.uk/privacy-policy

Name (required)

Email Address (required)

Date of birth (required)

Address including postcode (required)

RLSS UK Membership Number: (required)

Athletes Declared Results (list as many as possible including the RLSS National Lifesaving Championships, RLSS Speeds events and other events such as SLSGB, SPEED Series BULSCA etc.) Please list events in preferred order. (lack of provided information may reduce your opportunity for selection) National/International Event Name Event (100 carry, 50 carry, 100 tow etc.) Results

Athletes Declared Results (required)

I am declaring for the National Team (required)

I confirm that, if I am selected for Team Northern Ireland, I will pay an initial deposit of £100 within 7 days of the squad announcement and the full payment must be paid to RLSS UK by 31/08/2019. (required)

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