ZONE TRIALS ATHLETE REGISTRATION FORM (New Fax No.)

PORT ALBERNI TRACK AND FIELD CLUB

This form must be submitted to AVTC by 6:00 pm, Saturday, June 3rd.  You can email completed form to smacauley@telus.net or fax to (250) 724-0513, ATTN:  Terrie Pighin.  Payment for regular trials events will be accepted NO LATER than NOON, on Saturday, June 10th.  LATE registration will result in a doubling of the fee and be accepted no later than one hour before the event. 

 

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 participate.  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.

 

ENTRY DEADLINE: Saturday, June 3rd at 6:00 pm.

The cost is $3.00 per event and $12.00 per pentathlon. 

Late entry fees are $6.00 per event and $12.00 per pentathlon. 

An additional charge of $3.00 must be paid by athletes who are not competitive members of BC Athletics in order to cover day of event registration.  If athletes want to compete in other events, but not use them as a Summer Games Trial Event, they will pay $7.00 for one day or $12.00 for two days plus the $3.00 per trial event

_____ Events @ $3.00              _______               _____ Late Events @ $7.00                  _______   

_____ Pentathlon @ $12.00                  _______               _____ Late Pentathlon @ $12.00           _______

Day of Event Membership @ $3.00        _______               Day of Event Membership @ $3.00        _______

One Day of non-trial events @ $7.00      _______               One Day of non-trial events @ $7.00     _______

Two Days of non-trail events @ $12.00 _______              Two Days of non-trial events @ $12.00  _______  

 

TOTAL REGULAR ENTRIES               _______               TOTAL LATE ENTRIES                     _________