Registration Info:

Please enter information in the form below to process registration for event Glencar Lake Swim 25.

Glencar Distace *

500m

1km

3km

First Name * *

Last Name * *

Kayak Agreement *

By Ticking I agree to provide my own Kayaker for the 5km Distance

Gender: *

Male

Female

Date of Birth: (dd/mm/yyyy) *

Please use format dd/mm/yyyy

**Email Address** *

Confirm Email Address: *

Swim or Sports Club *

Emergency Contact Name: *

Emergency Contact Number: *

Any Medical Conditions that we may need to be aware of in event of Emergency: Please state *

Type Na if Not applicable to you

Waiver *

By Ticking I Agree I have read Agree with Waiver relating to Glencar Swim 2025

Waiver Download

Coupon

Amount

€

Discount

€

Processing Fee:

€

Gross Amount

€

Payment Method

By registering for this event, I accept Terms and Conditions