Bay State Short Track Championships
Saturday, November 21, 2009
11:00 a.m. – 7:00 p.m.
Iorio Arena, Walpole, Massachusetts
Eligibility:Registered speedskaters of the United States and Canada
Sanctioned By:US SpeedskatingHosted By:The Bay State Speedskating Club
Entries:Must be RECEIVED WITH ENTRY FEE by Tuesday, November 17, 2009.
Entry fee will be refunded if notification is received by 12:00 PM, Wednesday, November 18, 2009.
Fees:$25/skater ($60 family max), $10 for novices. U.S. funds, payable to Bay State Speedskating
Club.
LATE FEES:Please help us to make this event a success by registering early. REGISTRATIONS RECEIVED AFTER NOVEMBER 19, 2009 WILL BE ASSESSED A $20 LATE FEE.
Check-in:Iorio Arena, November 21: 9:30 A.M.-10:30 A.M. Skaters may be required to display U.S.Speedskating card or certification from US Speedskating Executive Director.
Time:Warm-ups start at 11:00 A.M.
Contact: ; Russell Curtis 508.697.9942
Emergency Tel:617.513.3883.
Location:Iorio Arena, Providence Highway (Route 1 northbound), South Walpole, MA (see directions on attached
page).
Requirements:Helmet #s on both sides of helmet, hard shell helmets, gloves, long sleeves, shin guards, neck guards.
The committee reserves the right to refuse any entry.
Awards:Awards for first, second, and third overall in each class as well as each novice.
Skaters must skate all events to be eligible for age-group trophies.
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Send This Section AND ATTACHED WAIVER With Check for Registration to:
Bay State Speedskating c/o Russell Curtis, 55 Dickens St, Bridgewater MA 02324
Name (Print)
Seed Times: 500 m ______Meet ______Date ______
1000 m ______Meet ______Date ______
Skating class (circle one only):Open A and Open B classes will be determined by seed times. Meet clerk has the authority to combine classes, but awards will be given for each individual class regardless of number of entrants.
Master A Master B Open A Open B Juvenile Midget Pony Peewee Novice A (Under 14) Novice B (Over 14) Special Needs
Sex (circle one)MFHelmet #______
Address______City______State______Zip______
Club ______Association______USS/SSC#______Phone______
ALL ENTRIES IN ALL CLASSES MUST SIGN AND SUBMIT THE ATTACHED WAIVER WITH YOUR APPLICATION. FAILURE TO DO SO WILL RESULT IN EXCLUSION FROM THE COMPETITION. NO EXCEPTIONS!
EVENTS (subject to change)
THE FOLLOWING AGE GROUPS WILL HAVE A STANDARD RACING FORMAT (Men and Women separately):
Master A50010001500Midget333 500 777
Master B500 7771000Pony222 333 500
Open A50010001500Pee Wee111 222 333
Open B500 7771000Novice A111 222 333
Juvenile500 7771000Novice B333 444 500
Men’s and women’s Open3000Special Needs 222 333 500
*Classes may be combined at the discretion of the clerk.
*Time permitting: Open Juniors (under 13) 1500 and men’s and women’s relays.
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LODGING AND DIRECTIONS TO IORIO ARENA
Local Hotels include:
Marriott Courtyard Norwood Holiday Inn Express Sharon Inn
Route 1 395 OLD POST ROAD Route 1
Norwood MA 02062 Sharon, MA 02067 Sharon, MA 02067
1-781-762-4700 or 1-800-321-22111-781-784-1000 1-800-879-5432
Directions to the Ted Iorio Arena at Walpole
Take Massachusetts Route 128 South, and exit onto Interstate 95 South. Continue on I-95 South to Exit 9 (Wrentham, U.S. Route 1). Proceed South on Route One. (You will see signs to "Gillette Stadium") Go through the first set of lights (Old Post Road). The Iorio Arena is a gray & black rectangular building about 1 mile down Route 1 on the left-hand-side, set back from the highway. Proceed past the Arena. You will see a sign "Next Exit All Turns." Exit right onto Pine Street. Immediately turn left and then left again onto Route 1. As you proceed north on Route One, the rink entrance (marked by a red-lettered sign on a gray background) will now be on your right.
WAIVER & RELEASE
NOTE: THIS FORM MUST BE READ AND SIGNED BEFORE THE PARTICIPANT IS PERMITTED TO TAKE PART IN THE BAY STATE CHAMPIONSHIP COMPETITION ON NOVEMBER 21, 2009, IN WALPOLE, MASSACHUSETTS. BY SIGNING THIS AGREEMENT, THE PARTICIPANT AFFIRMS HAVING READ IT.
IN CONSIDERATIONof my involvement in the sport and activities under the auspices of The Northeast Speedskating Association and the Bay State Speedskating Club, I acknowledge, appreciate, and agree that:
1. I RISK BODILY INJURY, INCLUDING PARALYSIS, DISMEMBERMENT, DISABILITY, AND DEATH, AND while particular rules of my sport, equipment, and personal training and discipline may reduce this risk, THIS RISK OF INJURY DOES EXIST, AS WELL AS THE RISK OF DAMAGE TO OR LOSS OF PROPERTY.
2. I KNOWINGLY AND FREELY ASSUME ALL SUCH RISKS, both known and unknown, EVEN IF ARISING FROM THE NEGLIGENCE OF THE RELEASEES OR OTHERS;
3. I willingly agree to comply with the stated and customary terms and conditions for participation. If, however, I observe any unusual or unnecessary hazard during my presence or participation, I will bring such to the attention of the nearest official; and
4. I, FOR MYSELF AND ON BEHALF OF MY HEIRS, ASSIGNS, PERSONAL REPRESENTATIVES, and NEXT OF KIN, HEREBY RELEASE, HOLD HARMLESS, and PROMISE NOT TO SUE THE NORTHEAST SPEEDSKATING ASSOCIATION, THE BAY STATE SPEEDSKATING CLUB, US SPEEDSKATING, OR OTHER SPONSORING ORGANIZATIONS, THEIR OFFICERS, VOLUNTEERS, STAFF, SPONSORS AND/OR AGENTS (“RELEASEES”), WITH RESPECT TO ANY AND ALL INJURY AND LOSS ARISING FROM MY PARTICIPATION, WHETHER CAUSED BY THE NEGLIGENCE OF THE RELEASEES OR OTHERWISE, EXCEPT THAT WHICH IS THE RESULT OF GROSS NEGLIGENCE OR WANTON MISCONDUCT.
I have read this Release of Liability and Waiver Agreement, fully understand its terms, and sign it freely and voluntarily.
Participant’s Signature ______Date ______
Participant’s Name (Printed) ______
FOR PARTICIPANTS OF MINORITY AGE
(Under Age 18 at the Time of Registration)
This is to certify that I/we as parent(s)/guardian(s) with legal responsibility for this participant, do consent and agree not only to his/her release, but also for myself/ourselves, and my/our heirs, assigns, and next of kin to release and indemnify the Releases from any and all Liability incident to my/our minor child’s involvement as stated above.
Parent/Legal Guardian Signature ______Date ______
Parent/Legal Guardian Name (Printed) ______
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