Petition to keep Harlech Swimming Pool Open

Full name and contact details:

First Name <-- please enter your First Name

Last Name <-- please enter your Last Name

House No. & Street

Address (cont.)

Town / City <-- please enter a valid Town

County

Post Code

Country

E-mail

I am willing for my name and home town to be shown on the Harlech Triathlon web site.

My personal comments:

First Name	<-- please enter your First Name
Last Name	<-- please enter your Last Name
House No. & Street
Address (cont.)
Town / City	<-- please enter a valid Town
County
Post Code
Country
E-mail