The Purdue Area Track Club (PATC)
Elementary Track & Field Meet
(Pre-K through 6th Grade)
Sunday, February 12th, 2012(please check in 30 minutes before your 1st event)
@ Lambert Fieldhouse, Purdue University
Limitations:No more than 3 events for each athlete
Pre-Registration only: All entries and fees due by Thursday, February 9th!
Entry Fee:$5 per event (cash or checks payable to “PATC”)
Awards:Ribbons for all participants
There will be no same day registration!
The Purdue Area Track Club (staffed by the West Lafayette JH and HS coaches) summer information flyers will be available at the check in table on Sunday afternoon.
Club membership is not required for this meet, only event entry fees ($5 each event).
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12:15 PMLong Jump (3 attempts)
Shot Put (3 throws, 6 lb. Shot)
Turbo Jav (3 throws, 300 gram Jav)
1:30 PM55m Hurdles (3 flights of hurdles or “Banana Steps”)
Pre-K-K (12” Banana steps)
1st – 2nd (18” Banana steps)
3rd – 4th Grade (22” hurdles)
5th – 6th Grade (26” hurdles)
*The following time schedule is approximate!
2:00 PM*55m Dash
2:30 PM*1600m Run
2:45 PM*400m Dash
3:00 PM*200m Dash
3:30 PM*Completion of meet
(Over)
PATC West Lafayette Schools Meet
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Athlete’s name ______|Parent/guardian name ______
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Birth Year: ______Grade: ______|I am available to help! email ______
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Circle gender:MF|(circle)TimerField Event_____
Circle Grade level:Pre-K - K1-23-45-6
Circle Events:Long JumpShot PutTurbo Jav55H55D
(Max. 3 events)
1600400200# of events (__) X $5 = ____
Athlete Release(cash or checks payable to “PATC”)
In consideration of this entry being accepted, I/we shall be legally bound and do release for myself, heirs, executors and administrators any claim for loss, injury or damage which might occur during participation in or traveling to and from the PATC West Lafayette Schools Meet and do hereby release USA Track & Field, Indiana USA Track & Field, Purdue University, the Purdue Area Track Club, meet officials & volunteers and others assigned from any claims. I/we grant permission to the meet directors, coaches and chaperones to set upon this athlete as a guardian/spokesman in granting permission for the use of emergency medical treatment including anesthesia if necessary. I understand that should a health emergency arise, an attempt will be made to notify parents/guardians, but that authorization is hereby granted.
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Signature – Athlete (if possible) Signature - Parent/guardian
Phone: Home ______Work ______Cell ______
List allergies & current medications: ______
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Parking: Park in Northwestern Street garage, north of football stadium or anywhere near Lambert Fieldhouse. Enter at either end of the Fieldhouse.
Questions: Lane
Hand in registration with entry fee in an envelope to Lane Custer at Happy Hollow School, the Office at Cumberland School or send to: Lane Custer
296 Park Lane
West Lafayette, IN 47906
All entries and entry fees must be received by Thursday, February 9th!
Please do not put two athletes on 1 registration sheet!
(There will be no same day entry. Check-in is 30 minutes before your 1st event)
(Over)