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PRINT THIS PAGE AND COMPLETE THE ENTRY FORM
ENTRY FORM CHANGES
- The individual entry blank now contains biographical information
normally required at registration.
Please fill out this section in its entirety.
- The relay entry blank now requires the same information as that
for individual entries.
- Use the same relay entry blank for Youth events as with high schools.
- Note addition of a new event, the Freshman Mile.
- Use one entry form per relay. You may make copies of the entry
form.
RELAY ENTRY BLANK (use this for youth relay
events as well). PLEASE PRINT LEGIBLY
Standard (scholastic) Relays: $95 per relay
Youth (bantam, midget, youth): $30 per relay
NO DAY OF MEET ENTRY! *** USE BLACK INK *** NO FAXED ENTRIES!
(*** ENTRY WILL BE REJECTED AND RETURNED IF RELAY NAMES ARE NOT
LISTED)
--- MAXIMUM 5 ATHLETES PER RELAY --- ENTER ONE RELAY PER RELAY ENTRY
FORM ---
--- RELAY MEMBERS MUST ATTEND THE SAME HIGH SCHOOL FOR NON-YOUTH
EVENTS. ---
Mail entries to: NSSF, PO Box 16702, Chapel Hill,
NC 27516 NO FAXED ENTRIES!
School (or club, for Youth)___________________________ City __________________
State ______
Coach's Name ____________________________________________
Phone ( )_____ - ____________
Relay (circle one): 4x200 4x400 4x800 4xMile
1600m Med DMR Hurd R Male Female (circle one)
Youth events (circle one): bantam 4x200
midget 4x200 youth 4x200 Male Female (circle one)
bantam 4x400 midget 4x400 youth 4x400
Qualifying Performance ______________ FAT / HAND
Meet _____________________ Date ___________
RELAY MEMBERS (Last Name, First Name)
***** NO HIGH SCHOOL ALL-STAR RELAYS PERMITTED *****
Name # 1 ________________________ _________________________________
____ (Last First MI )
Phone ______ ______ - __________ e-mail__________________________________________
Home Address_______________________________ City __________________
State _____Zip________
USATF#_______________Birthdate (mm/dd/yy)___________Graduation
Year ________Sex: M F (circle one)
Name # 2________________________ _________________________________
____ (Last First MI )
Phone ______ ______ - __________ e-mail__________________________________________
Home Address_______________________________ City __________________
State _____Zip________
USATF#_______________Birthdate (mm/dd/yy)___________Graduation
Year ________Sex: M F (circle one)
Name # 3________________________ _________________________________
____ (Last First MI )
Phone ______ ______ - __________ e-mail__________________________________________
Home Address_______________________________ City __________________
State _____Zip________
USATF#_______________Birthdate (mm/dd/yy)___________Graduation
Year ________Sex: M F (circle one)
Name #4 ________________________ _________________________________
____ (Last First MI )
Phone ______ ______ - __________ e-mail__________________________________________
Home Address_______________________________ City __________________
State _____Zip________
USATF#_______________Birthdate (mm/dd/yy)___________Graduation
Year ________Sex: M F (circle one)
Name # 5 ________________________ _________________________________
____ (Last First MI )
Phone ______ ______ - __________ e-mail__________________________________________
Home Address_______________________________ City __________________
State _____Zip________
USATF#_______________Birthdate (mm/dd/yy)___________Graduation
Year ________Sex: M F (circle one)
WAIVER: In consideration of the above athletes entry
in the Nike Indoor Classic; I automatically waive and release all
claims for damages and injury I may have against the competition
and all its sponsors including, but not confined to the National
Scholastic Sports Foundation, Inc., Prince George's Sports and Learning
Complex, Nike, Inc., and any and all participating sponsors and/or
representatives. I verify they are physically fit and have trained
for this competition. I further grant full permission to any and
all of the foregoing and/or their representatives to use any photographs,
name, and/or video for legitimate purposes.
Coach's Name __________________________________
Signature _____________________________________
Nike Indoor Classic 2002
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