Rotary Clubs of Portsmouth & Southsea
and Southse Castle

Charity Dragon Boat Festival Saturday 19th May and Sunday 20th May 2012

Registration of Interest

Company/Organisation: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 
Team name: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 
Team contact: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 
Address: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 
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Telephone: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 
Mobile: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 
Email: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 

Which day(s) are you interested in competing? Saturday 19th or Sunday 20th?

Please return your completed form to:

Mark Esbester
9 Hambledon Road
Clanfield
WATERLOOVILLE
PO8 0QU
023 9259 5794

mark.esbester@ntlworld.com

When you return this form we will send you all the information and details to help you recruit your team and book a space in the programme.