ZONE 6 BC SUMMER GAMES ATHLETE REGISTRATION FORM

[Attention: Tom Dingle]

This form must be submitted with payment deposits (cheque, credit card number, or a note from the club saying that the fee will be paid by the club), to Diana Hollefreund, at the AVTC Registration Table during the Trials Meet in Port Alberni. ATHLETES WILL NOT BE CONSIDERED FOR THE ZONE 6 TEAM IF THIS FORM HAS NOT BEEN HANDED IN BEFORE THE SELECTION MEETING ON SUNDAY AFTERNOON. Athletes who are not selected to the Zone 6 Team will have all deposits returned.

NAME: ___________________________________ M/F BCA # ___________

ADDRESS ____________________________________ CITY ____________

POSTAL CODE _______________________ PHONE NUMBER _______________

E-MAIL ADDRESS ______________________________________________________

BIRTHDATE ____/____/____ BIRTH CERTIFICATE NUMBER _______________

DAY MONTH YEAR

SCHOOL ____________________________________________________________

Please list the events in which you would like to compete in the Summer Games.

Please enter your seasonal best on the line beside each event entered.

80 m/100 m hurdles __________ High Jump __________

300 m hurdles __________ Long Jump __________

100 metres __________ Triple Jump __________

200 metres __________ Pole Vault __________

400 metres __________ Discus __________

800 metres __________ Hammer __________

1500 metres __________ Javelin __________

3000 metres __________ Shot Put __________

1500 m Racewalk __________

1500 metre Steeplechase __________ Pentathlon __________

Note: Relay team members will be selected from the zone team after the selections.

Midget athletes may try out for the pentathlon and other events as well, but if they are chosen to the Zone 6 Team for the pentathlon, they will not be able to compete in any other event at the Summer Games except possibly in a relay.

CHARGES IF SELECTED TO THE ZONE TEAM

1. $75.00 payment to the BC Athletics at time of selection to the team __________

2. $15.00 to BC Athletics for the Shirt at time of selection to the team __________

3. $20.00 and SG registration forms for BC Athletics if not a member __________

T-SHIRT INFORMATION

The shirts are short sleeved in each zone’s colour. You must compete in the zone shirt at all times and may not alter the shirt in any way. The Kamloops Summer Games logo for Athletics will appear on the front of the shirt.

Shirt sizes are: SMALL MEDIUM LARGE EXTRA LARGE DOUBLE XL