Track & Field Camp/ Track & Field Meet

Camp Dates: June 18th and 19th

Time: 10:00 a.m.-2:30 p.m. Middle and High School Athletes

10:00 a.m.- 12:30 p.m. Preschool- elementary children

Lunch will be provided for all ages

Track Meet: June 20thstarting at 10 a.m.

Place for Camp and Meet: Zanesville High School Track

Cost: $45 Middle and High School Athletes for camp & track meet

$20 Preschool and Elementary Children for camp & track meet

Make checks payable to Team Godspeed, 3365 Dresden Road, Zanesville, OH 43701

Contact Christine Williams at 740.704.1754 for further details or visit

Last Name :______First Name: ______Age:____

Address: ______City:______

State:______Zip:______

E-mail:______HomePhone:______

Emergency Contact Name & Phone Number:______

___ Female ___Male Circle Shirt Size Youth: SM L Adult: S M L XL

Middle and High School Camp athletes, check the following for the 2 Day Camp (Areas of Interest):

___ Sprints ___ Hurdles ____ Mid/ distance ____ Long Jump ____High Jump ____ Throws ____ Pole Vault

For the Track meet, please mark (X) event/s of participation /or write down best performances if available:

Event / 100m / 200m / 100m H / 300m H / 400m / 800m / 1 Mile / Long Jump / High Jump / Throws / Pole Vault
Mark/Time
Relays / 4 x 100m / 4 x 200m / 4 x 400m
Mark/Time

WAIVER

The undersigned ("ATHLETE") on behalf of himself/herself and on behalf of Athlete's personal representatives, assigns, heirs, executors, hereby fully and forever release, waives, discharges and covenants not to sue Team Godspeed®, Zanesville Schools and all municipal agencies whose property and/or personnel are used, and all other sponsoring or co-sponsoring companies or individuals related to the Track and Field Camp (collectively "RELEASES") from all liability to the Athlete and his/her personal representatives, assigns, heirs, and executors, for all loss(es) or damage(s) and any and all claims or demands therefore, on account of inquiry to the Athlete or property or resulting in the death of an Athlete, whether caused by the active or passive negligence of all or any of the Releases or otherwise, in connection with the Athlete's participation in the Track and Field Camp. The Athlete represents and warrants that he/she is in good physical condition and is able to safely participate in the Track and Field Camp. The Athlete is fully aware of the risks and hazards inherent in participating in the Track and Field Camp, and hereby elects to voluntarily compete in the Track and Field Camp, knowing the risks associated with the Track and Field Camp. The Athlete hereby assumes all risk of loss(es), damage(s), or injury(s) that may be sustained by him/her while participating in the Track and Field Camp. The Athlete agrees to the use of his/her name and photographs in broadcasts, newspapers, brochures and other media WITHOUT ATHLETE permission or compensation. The Athlete acknowledges that the entry fee is non-refundable and non-transferable. The Athlete hereby consents to receive medical treatment which may be deemed advisable in the event of injury, accident and/or illness during the event.

Signature Date

Guardian Signature (If Under 18 Years of Age) Date