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info@limpopoaquatics.co.za
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Name
*
First
Last
Email
*
Phone
*
Course Date
Course Reference No - Get from Flyer
*
Which course are you attending, Starters or Referee's or Both?
*
Timekeeping
Judges
Starters
Referee
Limpopo District
*
Capricorn District
Mopani District
Sekhukhune District
Vhembe District
Waterberg District
First Name(s) as per your ID book:
*
Course Results (Office use Only)
School or Swimming Club
RSA ID number or Passport No
Gender
*
Male
Female
Other
Race (For EPG Stats)
African
Coloured
Indian
White
Have you Registered as a swimming official (Current season)
*
Yes
No
SSA Registration number (If Available)
Email Address (For course feedback)
*
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