Wisconsin Throws Pentathlon

Masters Midwest Regional Championship Throws Pentathlon & Elite Meet USATF Sanctioned
University of Wisconsin Whitewater Sunday, June 10, 2012 Time 10:00 a.m. Check One or Both and List Seeding Marks Below
_____Throws Pentathlon: Consists of five events, hammer throw, shot put, discus throw, javelin throw, and weight throw. Events will be scored using the International Athletics Association Federation score tables. Scoring is similar to the multi-events in track & field such as the decathlon. _____Elite Meet: Event specific athletes may enter into a single event and receive six throws with the acceptance of a Championship Level mark or just cause. Entries are welcome but discretion of acceptance will be used, as we are encouraging entry into the Pentathlon. USATF Membership REQUIRED.

Hammer______ Shot_______ Discus_______ Javelin_______ Weight_______

Last Name______________________ First Name________________________ Male Female (Circle One) HS Collegiate Open/Masters (Circle One)

USATF # _________________________________ Age (on 6/10/2012)_______ 2012 USATF Membership (Required) for non-collegiate athletes competing in the Throws Pent Address__________________________________________________________ City__________________________ State_______ Zip Code________________ Phone________________________ Email______________________________

Registration Fees Throws Pentathlon $30 HS/Collegiate $60 Non-Collegiate/Masters

Elite Meet $25 HS, Collegiate, Non-Collegiate, Masters

Those who register by May 21th will receive a free technical shirt otherwise they will be sold at the meet.

Please make checks payable to Matthew Oldenburg Circle T-Shirt Size: Contact Persons
Matt Oldenburg Krista Hasselquist

XL

XXL

XXXL

4XL

Phone
(262) 366 8821 (715) 417 0765

E-Mail & Websites

throwspent@gmail.com www.throwspentwi.com

Mail registration, waiver, and check to:

Throws Pent 10820 N Cedarburg Rd Mequon WI 53092

Waiver: I do hereby legally bind myself, my heirs, executors, and administrators to waive, release and discharge any and all rights, claims and damages that I may have against USATF, USATF Wisconsin, Matthew Oldenburg, Krista Hasselquist, the University of Wisconsin Whitewater, their agents, volunteers, representatives, employers or sponsors for any and all injuries, damages and/or claims which might otherwise have arising out of said event. I hereby attest that I have full knowledge of the risk involved in competing in this event and am physically fit and sufficiently trained to participate in this event. By entering this competition, I grant USA Track & Field, Inc. a limited license to use my name, likeness, image, voice, video, athletic performance, biographical and other information, in any format whatsoever, and to distribute, broadcast and exhibit these without charge, restriction or liability, but only for the purposes of advertising or promoting the sport of Athletics. In no event, however, will such usage constitute an endorsement of any product or service without my specific written consent. Signature (required)___________________________________Date___________