	Recognised by Sport England as the Governing Body for Pool in England

2024 EPA Wheelchair Tour Application

To register your interest in joining any EPA Tour, please fill out and submit this web form. Sending this form only registers your interest and does not guarantee a place on a tour until after your application has been approved and your deposit has been received.

Please take particular care with typing your own Email address correctly.

The form you submit will be sent back to yourself for your own records, so if you do not receive it in your own inbox within a reasonable time (say within 1 hour maybe), then the chances are that you mis-typed your own email address.

If this happens, please submit the form again because we cannot recover your lost Email.

Yellow items with a red border are mandatory.

This form MUST be submitted for ALL tour event registrations including full tour, individual events and private purchases.

Payment Details …

2024 Wheelchair Tour:

EPA Sort Code: 20-84-58
EPA Account No: 90678430
All payments due within 3 days of registration please.
5 Events - Click here for the event programme, venues and dates.
Full Fee: £150 by 1^st May.
Individual Event Fee: £40 each.

Name:

Tour:

I am Registering for:

Event 3

Event 4

Event 5

I am Buying from Someone Else:

EPA Registered County:

Mobile Phone No:

Email:

Confirm Email:

Date of Birth:

Comments:

Notes …

Anything else that you would like to add to this registration form.

Confirmation …
I confirm that I understand that submitting this form does not guarantee entry into the event.
I understand that a deposit payment will need to be received before this application for the Tour is accepted.

Type the security text above (numbers and letters):