SCDLBA Mixed Medley 2018

Team Nomination (First 16 teams nominated and paid in full will be accepted).

Ladies

Men

Contact Details

Nomination Fee by Direct Deposit / Online Banking

Pay to: SCDLBA, BSB 484799 Account Number 027074379

When you pay, the Reference in your online banking should be Lady Skip Surname & "MED" eg. SMITH-MED

Once paid, please enter the receipt number FROM the bank payment into this field below