Puget Sound Short Track Speed Skating Challenge
HOSTED BY: Puget Sound Phoenix Speed skating Club
Date: December 20, 2015 (Sunday) from 1:15 p.m. until ~ 6:30 p.m.
Location: Puget Sound Hockey Center,
1918 Stewart Street, Tacoma, WA, 98421
CHECK IN: 1:15 p.m. ~ 1:45 p.m. (2nd Floor)
WARM UP: 2:00 p.m. ~ 2:20 p.m.
RACING: 2:30 p.m. ~ 5:30 p.m.
ENTRY FEE: $30 per skater ($70 maximum per family)
ENTRY DUE DATE: December 14, 2015 (Monday before the competition.)
All skaters must be members of U.S. Speed skating or Speed Skating Canada. NOTE: This is NOT a U.S. Speedskating sanctioned competition.
Meet Director: Chang Lee (Club Coach)
For more information contact: Jan Zurcher, (253) 709-2340
Mail or e-mail entries. Payment can be made at rink on race day.
Make checks payable to: Puget Sound Speed skating Club or PSSC
Mail to: / 31811 Pacific Highway SouthSuite B - #373
Federal Way, Washington
98003 / E-mail to: /
Competition will be run using an ability meet format. All skaters will skate 3 distances.
Trophys will be given to the all skaters by age class (advanced and novice).
Required Equipment: Helmet, cut resistant gloves, long sleeves, neck protection, knee pads and shin guards. Recommended: Eye protection, cut-proof liner suit.
Schedule (All skaters will skate 3 distances):
2:00 -- 2:10 – Warm up (Advanced skaters)
2:10 – 2:20 – Warm up (Novice skaters)
2:40 – 5:30 – Races [ice cut before 1st distance, after a set of races (track only)]
6:00 – 6:30 – Awards
ENTRY FORM
Name: First:______Last:______Club: ______
Street Address: ______
State:______Zip:______E-mail: ______
Phone: ______Birth Date: MM:______/DD:______/YYYY______Age (as of 7/1/15):______
U.S. Speed skating Number: ______Male:______Female: ______
Class (Please circle): Beginners (A&B), Pee Wee (8 and under), Pony (9-10), Midget (11-12), Juvenile (13-14), Open (Ages 15+), Open B (ages 15+), Masters (40+).
Seed Time: Ponies & under/Beginner: 333 m ______, Midgets & over: 500 m ______
Signature: ______Amount Enclosed $:______
Parent Signature (If under 18 years of age): ______
*****Must have signed waiver******
WAIVER & RELEASE
Puget Sound Short Track Speed skating Challenge
Puget Sound Hockey Center
December 20, 2015
NOTE: This form must be read and signed before the participant will be permitted to take part in the Puget Sound Short Track Speed skating Challenge on December 20, 2015. By signing this form, the participant affirms having read and understood it.
IN CONSIDERATION of my involvement in the sport and activities under the auspices of U.S. Speed skating and/or the Puget Sound Speed skating Club and/or the Tacoma Hockey Association, 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, personal training and discipline may reduce this risk, this risk of injury does exist, as well as the risk of damage 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 Releases or of any other person.
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 and hold harmless and promise not to sue U.S. Speed skating, Puget Sound Speed skating Club, Tacoma Hockey Association, any sponsoring organizations, any official, volunteer or staff member, sponsors and/or agents or any other person (“Releases”) with respect to any and all injury and/or loss arising from my participation whether caused by the negligence of the Releases or otherwise.
I have read this Release of Liability and Waiver Agreement, fully understand its terms and sign it freely and voluntarily.
Participant’s Signature: ______
Participant’s Name (Printed): ______Date: ______
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.