Meet Information
KTCCCA Indoor State Championships
Mason County Indoor Athletic Complex
725 Clarks Run Rd
Maysville, Kentucky 41056
March 7 Class AAA High Schools & Masters & Middle School
March 14 Class A & AA High Schools
Note: Due to cancellation of the Mason-Dixon Games, the KTCCCA has decided to host an indoor state championship. Proceeds from this meet will be earmarked for assistance in re-establishing the Mason-Dixon Games in 2017.
ENTRIES; All entries will be done online at www.kytrackxc.com
NOTE: Remember individuals may not participate in more than 4 events.
Performances for 3000 entries and 4x800 relay must have been achieved between January 1 and March 3, 2015(for Class AAA) and March 10, 2015 for Classes A & AA. Performances must be verifiable on www.kytrackxc.com Performances are base on 3000 meter time or equivalent(3200, 2 Mile, etc will be converted). Notification of qualifiers will be emailed & posted March 4 (AAA) and March 11 (A & AA).
RELAYS : We realize that names will change on meet day but do the best you can at
getting your names right. Make sure you have anyone who might compete listed as an
alternate on the relays. You may list 8 on the relay entry.
ENTRY FEES: This meet will not have a separate fee for the individual entries.
One athlete could win this meet if they are talented enough, therefore they must pay the
full team entry fee. A boys team entry is $75.00 if received by the entry deadline, if late the
entry fee is $100.00. A girls team entry is $75.00 if received by the entry deadline, if late the
entry fee is $100.00. Entry fee must be received by March 3 for AAA & MS, March 10 for
A & AA. Checks delivered on meet day will be considered late. Get your entry fees in NOW.
A slow bookkeeper is not an excuse.
Along with the entry fee, all coaches that enter the meet must be a current (2014-2015) member of the
Kentucky Track and Cross Country Coaches Association. A membership form is included. If in doubt, contact Teejayking@gmail.com
Please Do Not Send Cash: Make checks for entry fees to: KTCCCA
Mail to: Tim King 1106 Sycamore St. Falmouth KY 41040
Checks for membership should be made to the KTCCCA & mailed to Tim King 1106 Sycamore St. Falmouth KY 41040
Events Middle School 55, 1600, 400, 800, 4x400 Relay, Long Jump, Shot Put
Unlimited entries in all events except in the long jump(limit of two entries), one relay team
Events High School 4x800 Relay, 55 Hurdles, 55, 1600, 400, 800, 3000, 4x400 Relay, Long Jump, Triple Jump, High Jump, Shot Put, Pole Vault(Note pole vault contested on March 1 @ Fuzion Athletics-Shelbyville.
Unlimited entries 55H, 55, 1600, 400, 800, shot put, limit of two entries long jump, high jump, triple jump, 1 relay team
Events Masters & Open 55H, 55, 1600, 400, 800, long jump, triple jump, high jump, pole vault
ENTRIES: All high school and middle school entries will be done online at www.kytrackxc.com . Masters-Open entries will be paper entries. See entry form below.
Please acquaint yourself with the milesplit online procedures. Entries must be entered
By March 3 for Class AAA and Middle School, by March 10 for Class AA and Class A
Awards: Team awards will be presented to the top 2 teams and will be presented as soon as possible
at the end of each division. Individual awards will be medals for the top 3 places and
ribbons for the next 5 places. Only the top two per team will score.
Scoring: 10 8 6 5 4 3 2 1
General Information: General Admission $5.00 per person
MOTELS
Quality Inn $65.00 + tax = $72.35 606-759-5696 1 mile from the track
1428 A U.S. Hwy 68 Maysville, KY 41056
Indoor heated pool & spa, complimentary deluxe continental breakfast, handicap facilities, free local calls, cable TV with HBO,
free weekday copy of USA Today, free parking, bus parking.
Days Inn $58.00 + tax =approx. $65.72 606-564-6793 2 miles from the track
Located behind McDonalds mention indoor track meet rate 484 Moody Drive Maysville, KY 41056
Generous size rooms and suites with plenty of working space, direct-dial phones, meeting rooms, cable TV, outdoor pool and
tennis court.
French Quarter $75.00 + tax = $83.52 606-564-8000 3 miles from the track
25 East McDonald Parkway Maysville, KY 41056 www.FrenchQuarterInn.com
A Southern Taste of Hospitality New Orleans style. Spacious suites with executive desks. Each room features over-sized deep
whirlpool tub. Meeting room, full service restaurant, and outdoor pool.
Hampton Inn $75.00 + tax = $83.52 606-759-0600 1 mile from the track
503 Market Place Drive Maysville, KY 41056 www.hamptoninn_hilton.com
62 Rooms, King & Jacuzzi Suites. Indoor Pool, Business Center, Exercise Room, Hot Breakfast.
Super 8 Motel $66.10 (tax already included) 606-759-8888 1 mile from the track
550 Tucker Drive Maysville, KY 41056 www.super8.com
Whether for business or pleasure, the award winning Maysville Super 8 Motel offers 44 rooms and two suites. Complimentary
continental breakfast, microfridges, computer available in lobby, dataport phones, large truck parking.
ENTRY DEADLINE: March 3 for AAA & Middle School. March 10 for Class A & AA
All entries for high school and middle school will be done online at www.kytrackxc.com
MAIL ENTRY FEE CHECKS TO:
KTCCCA
1106 Sycamore St. Falmouth KY 41040
MEET TIME SCHEDULE IS AS FOLLOWS
Remember we will be on a Rolling Schedule
March 7
Class AAA, Middle School, & Masters & Open
10:00 Rolling Schedule Middle School-Master & Open Divisions
Events Girls will go first in all the running events
55 Meter Dash MS followed by masters
1600 Meter Run MS followed by masters
400 Meter Dash MS followed by masters
800 Meter Dash MS followed by masters
1600 Meter Relay MS Only
3000 Masters Only
1500 Meter Racewalk
55 Meter Hurdles Masters & Open Only
9:30 Masters & Open Triple Jump (Open Pit) followed by Masters & Open Long Jump
9:30 Masters & Open Men & Women Shot Put Girls Shot Put 10:00 followed by Boys Shot Put
Girls Long Jump (Open pit 10:00-11:00) followed by Boys Long Jump (Open Pit 11:00-12:00)
Masters & Open Men & Women High Jump 11:00
Each athlete receives 3 throws/jumps with no finals.
Masters/Open Pole Vault will be conducted at Fuzion Athletics March 1
3:00 Class AAA Saturday March 7 (NOTE: Pole Vault will be conducted at Fuzion Athletics, Shelbyville, Kentucky on March 1. See below
3200 Meter Relay (time standard for 4x800 achieved between Jan 1 and Mar 1 girls 10:45, boys 9:10)
55 Meter High Hurdles (BLOCKS REQUIRED)
55 Meter Dash (BLOCKS REQUIRED)
1600 Meter Run
400 Meter Dash(NO BLOCKS)
800 Meter Dash
3000 Meter Run (time standard for 3000 achieved between Jan 1 and Mar 1 girls 12:30, boys 10:30)
1600 Meter Relay(NO BLOCKS) Girls will go first in all the running events
Girls & Boys Triple Jump(Open Pit 3:00-3:45)
Girls Long Jump (Open pit 3:45-4:45) followed by Boys Long Jump (Open Pit 4:45-5:45)
Girls Shot Put (3:00) followed by Boys Shot Put
Boys High Jump (3:00) (starting height 5-2) followed by girls high jump(starting height 4-2)
Each athlete receives 3 throws/jumps with no finals.
Pole Vault will be conducted at Fuzion Athletics-Shelbyville, Ky March 1
9:30 Class A Saturday March 14 (NOTE:Pole Vault will be conducted at another site earlier
than this date. More information later)
Girls will go first in all the running events
3200 Meter Relay(time standard for 4x800 achieved between Jan 1 and Mar 1 girls 12:00, boys 10:30)
55 Meter High Hurdles (BLOCKS REQUIRED)
55 Meter Dash (BLOCKS REQUIRED)
1600 Meter Run
400 Meter Dash(NO BLOCKS)
800 Meter Dash
3000 Meter Run (time standard for 3000 achieved between Jan 1 and Mar 1 girls 13:00, boys 11:00)
1600 Meter Relay(NO BLOCKS)
Girls & Boys Triple Jump(Open Pit 9:30-10:15)
Girls Long Jump (Open pit 10:15-11:15) followed by Boys Long Jump (Open Pit 11:15-12:15)
Girls Shot Put(9:30) followed by Boys Shot Put
Boys High Jump(9:30) (starting height 5-2) followed by girls high jump(starting height 4-2)
Each athlete receives 3 throws/jumps with no finals.
Pole Vault will be conducted at Fuzion Athletics, Shelbyville, Kentucky on March 1. See below
3:30 Class AA Saturday March 14
3200 Meter Relay (time standard for 4x800 achieved between Jan 1 and Mar 1 girls 12:00, boys 10:00)
55 Meter High Hurdles (BLOCKS REQUIRED)
55 Meter Dash (BLOCKS REQUIRED)
1600 Meter Run
400 Meter Dash(NO BLOCKS)
800 Meter Dash
3000 Meter Run (time standard for 3000 achieved between Jan 1 and Mar 1 girls 12:30, boys 10:30)
1600 Meter Relay(NO BLOCKS) Girls will go first in all the running events
Girls & Boys Triple Jump(Open Pit 3:30-4:15)
Girls Long Jump (Open pit 4:15-5:15) followed by Boys Long Jump (Open Pit 5:15-6:15)
Girls Shot Put(3:30) followed by Boys Shot Put
Boys High Jump(3:30) (starting height 5-2) followed by girls high jump(starting height 4-2)
Each athlete receives 3 throws/jumps with no finals.
Pole Vault will be conducted at Fuzion Athletics, Shelbyville, Kentucky on March 1. See below
Pole Vault
2015 Kentucky USATF Masters/Open Pole Vault-KTCCCA Class A, AA, AAA Indoor Championships
March 1 Fuzion Athletics Indoor Facility 237 Bonniemere Road Shelbyville, Kentucky
http://www.fuzionathletics.com/
From Lexington:
Take Exit 43 Ky 395, turn right, go 1.7 miles to Rt. 60, go 5.5 miles, turn right on Bonniemere. Go .2 miles
From Louisville
Take Exit 35, KY 53, turn left, go 2.0 miles to Rt. 60, turn right, go 5.5 miles, turn left on Bonniemere, Go .2 miles.
10:00 AM Masters/Open
1:30 High School Girls Class A, AA, AAA will vault together, scored separately March 7 & 14 in the team championships opening height 6-0 Limit of 2 vaulters per school
4:30 High School Boys Class A, AA, AAA will vault together, scored separately March 7 & 14 in the team championships opening height 9-0 Limit of 2 vaulters per school
Please note: athletes can vault only in one division. They cannot vault both the open and the high school division. USATF memberships are required for the open/masters division.
Coach and/or school representative must be present for athletes to compete in the high school division.
Limited seating is available. You may want to bring you own lawn chair.
Admission will be $5.00
MASTERS & OPEN ENTRY FORM
Kentucky USATF Indoor Championships
March 7, 2015
Mason County Indoor Athletic Complex, Maysville, Kentucky
(Pole Vault March 1 at Fuzion Athletics, Shelbyville)
Name_____________________ Sex M F 2015 USATF #_________________________
Email address___________________________ Birthdate (Month, day, year)_________________
Contact Patty Rouse Prouse23@windstream.net to see if your age has previously been verified or for more information on USA Track & Field membership as well as club membership.
Events (circle maximum of four) 55H 55 dash 200 400 800 1600, 3000 Shot Put High Jump Long Jump Triple Jump Pole Vault, 1500 Racewalk
Athletes Release: In consideration of your acceptance of my entry into the Kentucky USATF Track & Field Indoor Championships, I
voluntarily agree to participate in the KTCCCA Indoor Championships and knowingly assume any and all risk of loss, damage, property loss, injury (including death), both foreseen and unforeseen, of my attendance at and participation in the Kentucky USATF Indoor Championships from any cause whatsoever. I, for myself, my heirs, personal representatives and assigns do hereby release, waive, discharge and covenant not to sue USA Track & Field, Inc., the Kentucky USATF Association, Mason County High School, Kentucky Track & Cross Country Coaches Association and the Mason County Board of Education in which the Kentucky USATF Indoor Championships are held (collectively Releases) from all liability, loss, claims, demands, possible causes of action, court costs, settlement costs and fees, attorneys fees and any other expenses arising from any claim or lawsuit that may arise from any loss, damage or injury (including death) to me or my property resulting from or arising in connection with, or related to, my attendance at or participation in the Championships. I/we grant permission to the Meet Directors or their designee or the assigned Chaperones of any USA Track & Field competition or program to act as guardian/spokesman with full authorization and power to authorize emergency medical treatment, including hospitalization and anesthesia, if medically necessary, for me while in route to/from or at the site of the KTCCCA Indoor Championships, competition or program. I/we understand that should a health emergency arise, I/we will be notified but if/we cannot be reached by phone such medical treatment as is deemed necessary by medical personnel under the circumstances presented is hereby expressly authorized.
_________________________________________________ ________________________________________________________
Signature - ATHLETE Signature - PARENT / GUARDIAN
(Must be signed if athlete is under 18 years of age.)
Telephone: (_________)_____________________________
List allergies and current medications: ________________________________________________
NOTE-Entry Deadline March 3. Pole Vault deadline February 25. Entry fee $20 per athlete pre-registered, $30 race day fee. Kentucky USATF Indoor Championships Mail to KTCCCA c/o Frank Miklavcic 319 Erin Way Frankfort, Ky 40601
Mason County Indoor Athletic Complex
725 Clarks Run Rd
Maysville, Kentucky 41056
March 7 Class AAA High Schools & Masters & Middle School
March 14 Class A & AA High Schools
Note: Due to cancellation of the Mason-Dixon Games, the KTCCCA has decided to host an indoor state championship. Proceeds from this meet will be earmarked for assistance in re-establishing the Mason-Dixon Games in 2017.
ENTRIES; All entries will be done online at www.kytrackxc.com
NOTE: Remember individuals may not participate in more than 4 events.
Performances for 3000 entries and 4x800 relay must have been achieved between January 1 and March 3, 2015(for Class AAA) and March 10, 2015 for Classes A & AA. Performances must be verifiable on www.kytrackxc.com Performances are base on 3000 meter time or equivalent(3200, 2 Mile, etc will be converted). Notification of qualifiers will be emailed & posted March 4 (AAA) and March 11 (A & AA).
RELAYS : We realize that names will change on meet day but do the best you can at
getting your names right. Make sure you have anyone who might compete listed as an
alternate on the relays. You may list 8 on the relay entry.
ENTRY FEES: This meet will not have a separate fee for the individual entries.
One athlete could win this meet if they are talented enough, therefore they must pay the
full team entry fee. A boys team entry is $75.00 if received by the entry deadline, if late the
entry fee is $100.00. A girls team entry is $75.00 if received by the entry deadline, if late the
entry fee is $100.00. Entry fee must be received by March 3 for AAA & MS, March 10 for
A & AA. Checks delivered on meet day will be considered late. Get your entry fees in NOW.
A slow bookkeeper is not an excuse.
Along with the entry fee, all coaches that enter the meet must be a current (2014-2015) member of the
Kentucky Track and Cross Country Coaches Association. A membership form is included. If in doubt, contact Teejayking@gmail.com
Please Do Not Send Cash: Make checks for entry fees to: KTCCCA
Mail to: Tim King 1106 Sycamore St. Falmouth KY 41040
Checks for membership should be made to the KTCCCA & mailed to Tim King 1106 Sycamore St. Falmouth KY 41040
Events Middle School 55, 1600, 400, 800, 4x400 Relay, Long Jump, Shot Put
Unlimited entries in all events except in the long jump(limit of two entries), one relay team
Events High School 4x800 Relay, 55 Hurdles, 55, 1600, 400, 800, 3000, 4x400 Relay, Long Jump, Triple Jump, High Jump, Shot Put, Pole Vault(Note pole vault contested on March 1 @ Fuzion Athletics-Shelbyville.
Unlimited entries 55H, 55, 1600, 400, 800, shot put, limit of two entries long jump, high jump, triple jump, 1 relay team
Events Masters & Open 55H, 55, 1600, 400, 800, long jump, triple jump, high jump, pole vault
ENTRIES: All high school and middle school entries will be done online at www.kytrackxc.com . Masters-Open entries will be paper entries. See entry form below.
Please acquaint yourself with the milesplit online procedures. Entries must be entered
By March 3 for Class AAA and Middle School, by March 10 for Class AA and Class A
Awards: Team awards will be presented to the top 2 teams and will be presented as soon as possible
at the end of each division. Individual awards will be medals for the top 3 places and
ribbons for the next 5 places. Only the top two per team will score.
Scoring: 10 8 6 5 4 3 2 1
General Information: General Admission $5.00 per person
MOTELS
Quality Inn $65.00 + tax = $72.35 606-759-5696 1 mile from the track
1428 A U.S. Hwy 68 Maysville, KY 41056
Indoor heated pool & spa, complimentary deluxe continental breakfast, handicap facilities, free local calls, cable TV with HBO,
free weekday copy of USA Today, free parking, bus parking.
Days Inn $58.00 + tax =approx. $65.72 606-564-6793 2 miles from the track
Located behind McDonalds mention indoor track meet rate 484 Moody Drive Maysville, KY 41056
Generous size rooms and suites with plenty of working space, direct-dial phones, meeting rooms, cable TV, outdoor pool and
tennis court.
French Quarter $75.00 + tax = $83.52 606-564-8000 3 miles from the track
25 East McDonald Parkway Maysville, KY 41056 www.FrenchQuarterInn.com
A Southern Taste of Hospitality New Orleans style. Spacious suites with executive desks. Each room features over-sized deep
whirlpool tub. Meeting room, full service restaurant, and outdoor pool.
Hampton Inn $75.00 + tax = $83.52 606-759-0600 1 mile from the track
503 Market Place Drive Maysville, KY 41056 www.hamptoninn_hilton.com
62 Rooms, King & Jacuzzi Suites. Indoor Pool, Business Center, Exercise Room, Hot Breakfast.
Super 8 Motel $66.10 (tax already included) 606-759-8888 1 mile from the track
550 Tucker Drive Maysville, KY 41056 www.super8.com
Whether for business or pleasure, the award winning Maysville Super 8 Motel offers 44 rooms and two suites. Complimentary
continental breakfast, microfridges, computer available in lobby, dataport phones, large truck parking.
ENTRY DEADLINE: March 3 for AAA & Middle School. March 10 for Class A & AA
All entries for high school and middle school will be done online at www.kytrackxc.com
MAIL ENTRY FEE CHECKS TO:
KTCCCA
1106 Sycamore St. Falmouth KY 41040
MEET TIME SCHEDULE IS AS FOLLOWS
Remember we will be on a Rolling Schedule
March 7
Class AAA, Middle School, & Masters & Open
10:00 Rolling Schedule Middle School-Master & Open Divisions
Events Girls will go first in all the running events
55 Meter Dash MS followed by masters
1600 Meter Run MS followed by masters
400 Meter Dash MS followed by masters
800 Meter Dash MS followed by masters
1600 Meter Relay MS Only
3000 Masters Only
1500 Meter Racewalk
55 Meter Hurdles Masters & Open Only
9:30 Masters & Open Triple Jump (Open Pit) followed by Masters & Open Long Jump
9:30 Masters & Open Men & Women Shot Put Girls Shot Put 10:00 followed by Boys Shot Put
Girls Long Jump (Open pit 10:00-11:00) followed by Boys Long Jump (Open Pit 11:00-12:00)
Masters & Open Men & Women High Jump 11:00
Each athlete receives 3 throws/jumps with no finals.
Masters/Open Pole Vault will be conducted at Fuzion Athletics March 1
3:00 Class AAA Saturday March 7 (NOTE: Pole Vault will be conducted at Fuzion Athletics, Shelbyville, Kentucky on March 1. See below
3200 Meter Relay (time standard for 4x800 achieved between Jan 1 and Mar 1 girls 10:45, boys 9:10)
55 Meter High Hurdles (BLOCKS REQUIRED)
55 Meter Dash (BLOCKS REQUIRED)
1600 Meter Run
400 Meter Dash(NO BLOCKS)
800 Meter Dash
3000 Meter Run (time standard for 3000 achieved between Jan 1 and Mar 1 girls 12:30, boys 10:30)
1600 Meter Relay(NO BLOCKS) Girls will go first in all the running events
Girls & Boys Triple Jump(Open Pit 3:00-3:45)
Girls Long Jump (Open pit 3:45-4:45) followed by Boys Long Jump (Open Pit 4:45-5:45)
Girls Shot Put (3:00) followed by Boys Shot Put
Boys High Jump (3:00) (starting height 5-2) followed by girls high jump(starting height 4-2)
Each athlete receives 3 throws/jumps with no finals.
Pole Vault will be conducted at Fuzion Athletics-Shelbyville, Ky March 1
9:30 Class A Saturday March 14 (NOTE:Pole Vault will be conducted at another site earlier
than this date. More information later)
Girls will go first in all the running events
3200 Meter Relay(time standard for 4x800 achieved between Jan 1 and Mar 1 girls 12:00, boys 10:30)
55 Meter High Hurdles (BLOCKS REQUIRED)
55 Meter Dash (BLOCKS REQUIRED)
1600 Meter Run
400 Meter Dash(NO BLOCKS)
800 Meter Dash
3000 Meter Run (time standard for 3000 achieved between Jan 1 and Mar 1 girls 13:00, boys 11:00)
1600 Meter Relay(NO BLOCKS)
Girls & Boys Triple Jump(Open Pit 9:30-10:15)
Girls Long Jump (Open pit 10:15-11:15) followed by Boys Long Jump (Open Pit 11:15-12:15)
Girls Shot Put(9:30) followed by Boys Shot Put
Boys High Jump(9:30) (starting height 5-2) followed by girls high jump(starting height 4-2)
Each athlete receives 3 throws/jumps with no finals.
Pole Vault will be conducted at Fuzion Athletics, Shelbyville, Kentucky on March 1. See below
3:30 Class AA Saturday March 14
3200 Meter Relay (time standard for 4x800 achieved between Jan 1 and Mar 1 girls 12:00, boys 10:00)
55 Meter High Hurdles (BLOCKS REQUIRED)
55 Meter Dash (BLOCKS REQUIRED)
1600 Meter Run
400 Meter Dash(NO BLOCKS)
800 Meter Dash
3000 Meter Run (time standard for 3000 achieved between Jan 1 and Mar 1 girls 12:30, boys 10:30)
1600 Meter Relay(NO BLOCKS) Girls will go first in all the running events
Girls & Boys Triple Jump(Open Pit 3:30-4:15)
Girls Long Jump (Open pit 4:15-5:15) followed by Boys Long Jump (Open Pit 5:15-6:15)
Girls Shot Put(3:30) followed by Boys Shot Put
Boys High Jump(3:30) (starting height 5-2) followed by girls high jump(starting height 4-2)
Each athlete receives 3 throws/jumps with no finals.
Pole Vault will be conducted at Fuzion Athletics, Shelbyville, Kentucky on March 1. See below
Pole Vault
2015 Kentucky USATF Masters/Open Pole Vault-KTCCCA Class A, AA, AAA Indoor Championships
March 1 Fuzion Athletics Indoor Facility 237 Bonniemere Road Shelbyville, Kentucky
http://www.fuzionathletics.com/
From Lexington:
Take Exit 43 Ky 395, turn right, go 1.7 miles to Rt. 60, go 5.5 miles, turn right on Bonniemere. Go .2 miles
From Louisville
Take Exit 35, KY 53, turn left, go 2.0 miles to Rt. 60, turn right, go 5.5 miles, turn left on Bonniemere, Go .2 miles.
10:00 AM Masters/Open
1:30 High School Girls Class A, AA, AAA will vault together, scored separately March 7 & 14 in the team championships opening height 6-0 Limit of 2 vaulters per school
4:30 High School Boys Class A, AA, AAA will vault together, scored separately March 7 & 14 in the team championships opening height 9-0 Limit of 2 vaulters per school
Please note: athletes can vault only in one division. They cannot vault both the open and the high school division. USATF memberships are required for the open/masters division.
Coach and/or school representative must be present for athletes to compete in the high school division.
Limited seating is available. You may want to bring you own lawn chair.
Admission will be $5.00
MASTERS & OPEN ENTRY FORM
Kentucky USATF Indoor Championships
March 7, 2015
Mason County Indoor Athletic Complex, Maysville, Kentucky
(Pole Vault March 1 at Fuzion Athletics, Shelbyville)
Name_____________________ Sex M F 2015 USATF #_________________________
Email address___________________________ Birthdate (Month, day, year)_________________
Contact Patty Rouse Prouse23@windstream.net to see if your age has previously been verified or for more information on USA Track & Field membership as well as club membership.
Events (circle maximum of four) 55H 55 dash 200 400 800 1600, 3000 Shot Put High Jump Long Jump Triple Jump Pole Vault, 1500 Racewalk
Athletes Release: In consideration of your acceptance of my entry into the Kentucky USATF Track & Field Indoor Championships, I
voluntarily agree to participate in the KTCCCA Indoor Championships and knowingly assume any and all risk of loss, damage, property loss, injury (including death), both foreseen and unforeseen, of my attendance at and participation in the Kentucky USATF Indoor Championships from any cause whatsoever. I, for myself, my heirs, personal representatives and assigns do hereby release, waive, discharge and covenant not to sue USA Track & Field, Inc., the Kentucky USATF Association, Mason County High School, Kentucky Track & Cross Country Coaches Association and the Mason County Board of Education in which the Kentucky USATF Indoor Championships are held (collectively Releases) from all liability, loss, claims, demands, possible causes of action, court costs, settlement costs and fees, attorneys fees and any other expenses arising from any claim or lawsuit that may arise from any loss, damage or injury (including death) to me or my property resulting from or arising in connection with, or related to, my attendance at or participation in the Championships. I/we grant permission to the Meet Directors or their designee or the assigned Chaperones of any USA Track & Field competition or program to act as guardian/spokesman with full authorization and power to authorize emergency medical treatment, including hospitalization and anesthesia, if medically necessary, for me while in route to/from or at the site of the KTCCCA Indoor Championships, competition or program. I/we understand that should a health emergency arise, I/we will be notified but if/we cannot be reached by phone such medical treatment as is deemed necessary by medical personnel under the circumstances presented is hereby expressly authorized.
_________________________________________________ ________________________________________________________
Signature - ATHLETE Signature - PARENT / GUARDIAN
(Must be signed if athlete is under 18 years of age.)
Telephone: (_________)_____________________________
List allergies and current medications: ________________________________________________
NOTE-Entry Deadline March 3. Pole Vault deadline February 25. Entry fee $20 per athlete pre-registered, $30 race day fee. Kentucky USATF Indoor Championships Mail to KTCCCA c/o Frank Miklavcic 319 Erin Way Frankfort, Ky 40601