Name(Required) First Last Email(Required) Enter Email Confirm Email Phone(Required)Home Address(Required) Street Address Address Line 2 City State / Province / Region Eircode What county will you be swimming in?(Required)AntrimArmaghCarlowCavanClareCorkDerryDonegalDownDublinFermanaghGalwayKerryKildareKilkennyLaoisLeitrimLimerickLongfordLouthMayoMeathMonaghanOffalyRoscommonSligoTipperaryTyroneWaterfordWestmeathWexfordWicklowHow did you hear about September Sea Swim?(Required) Social Media Email From my company Friends/Family Radio Other Select AllI am happy to receive email updates on Childline’s work, future fundraising opportunities and how I can support(Required) Yes No