Entry Form

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ELIGIBILITY

• your local USATF association
• print and mail the USATF membership form
• on-line at USATF.ORG
• or on-site at the meet for $20.

ENTRY

Entry deadline is March 12, 2004. Entry fee is $35 for the first event, $15 for each additional event. Entry fee for the Pentathlon is $60 (the pentathlon does count as a first event). After March 12th, a late fee of $10 per event will be charged. No entries, additions and/ or changes will be accepted after March 23, 2004.

Relay registration will take place on-site only at $20 per team.

In order for a competitor's name to appear in the meet program and to receive final instructions, applications must be received by USATF- NE no later than March 5th.

Admission to the facility is free for all competitors and their guests.

HEADQUARTERS HOTEL

Headquarters hotel is The Westin Copley Place Boston, 10 Huntington Avenue, Boston - $116 single/ double, and $10 for additional people in a triple or quad. 1-800-WESTIN-1 or 1-617-262-9600.

To get the special rates reservations must be made by March 5, 2004; mention the National Masters Championships at the time of making your reservation. NOTE: If the hotel block fills, that rate will not be extended, even if it is before the deadline!

TRANSPORTATION

The Westin Hotel is one block from the Back Bay station. From there it is three stops on the MBTA ("The T") Orange line to the Roxbury Crossing station. Roxbury Crossing is across the street from the Reggie Lewis Facility. Allow at least 25 minutes to get to the track. A token to ride on the "T" is $1.25.

RESULTS

FinishLynx Automatic Timing. Results will be posted immediately on a stadium scoreboard. Hard copies will be posted in the gymnasium, and electronic results will be available at www.usatfne.org following the conclusion of the meet.

AWARDS

USATF Championship medals will be awarded to the top three places in each age group of each event final. Foreign athletes will receive a duplicate award. Championship patches will be presented to winners of individual events, however, will be limited to one patch per participant.

FRIENDS OF THE NATIONAL MASTERS CHAMPIONSHIPS

Help ensure the high quality of the Championships and future meets with a donation. All contributors will be listed in the official meet program and receive a full set of meet results. Please consider one of the following:

• Platinum $250 Platinum level contributors will receive an event bag, polo shirt, t-shirt and pin.
• Gold $100 Gold level contributors will receive an event polo shirt and pin.
• Silver $50 Silver level contributors will receive a meet T-shirt and pin.
• Bronze $25 Bronze level contributors will receive a pin.

THURSDAY NIGHT SOCIAL

There will be a dinner get-together on Thursday night at a local restaurant.

Schedule of Events (Subject to minor changes)

COMPETITION ORDER - TRACK EVENTS

FACILITY/IMPLEMENTS

Six lane, lightly banked 200 meter Mondo Track, eight lane straightaway. Use of starting blocks is restricted to those provided by the facility. All shoes will be checked, with only 1/4" pyramid spikes or flats permitted, no hexagonal elements. Acceptable spike implements will be available at the meet. There will be one weight and two shot circles, throwing onto a synthetic surface. Soft-shell shot and bag weight implements only, except for the Superweight (men 30-69), which will be contested outdoors.

Starting heights will be determined by facility equipment and meet officials. Minimum High Jump height will be 2 feet 8 inches; minimum Pole Vault height will be approx. 4 feet. Vaulters should bring their own poles.

There will be no 27 inch hurdles. Please refer to the implement rules that went into effect as in 2001.

2004 NATIONAL MASTERS INDOOR MASTERS TRACK & FIELD CHAMPIONSHIPS ENTRY FORM First Name Last Name Address City State Zip Country (if not USA) Telephone Male/Female Age (as of 3/26/04) Date of Birth Club/Affiliation 2004 USATF Number Citizenship (if not USA) Resident Alien (if not US citizen)? e-mail address  Event   Best Recent Performance   Fee Pentathlon (counts as first event)     ($60)   1.     ($35)   2.     ($15)   3.     ($15)   4.     ($15)   5.     ($15)   6.     ($15)   Late fee for entries postmarked after 3/12/04, # ______ events @ $10 each:   Total Entry Fees:     Masters Committee Surcharge (see note below)   5.00   T-shirt order (pre-event only) S___ M___ L___ XL___ XXL___ Total #______ shirts @ $13:     Friends' of the National Masters Championships Contribution ($250/100/50/25/other):   Thursday Night Social ($20 per person):     TOTAL AMOUNT ENCLOSED:   *The National Masters Track & Field Committee requires the Committee Surcharge. All such funds are forwarded to the Committee and are used for Committee representatives to attend and assist at Championship meets. All fees must be paid prior to the meet. Faxed entries will not be accepted. WAIVER AND RELEASE: In consideration of your accepting this entry into the National Masters Indoor Track & Field Championships, I hereby for myself, my heirs, executors and administrators waive and release any and all rights and claims for damages I may have against USATF, USATF- New England, its employees, agents, officers, the Reggie Lewis Track and Athletic Center, Roxbury Community College, the sponsors, the volunteers and their representatives, successors and assigns for any and all injuries suffered by me in said event, or as a result of my travel to and from the competition. I attest and certify that I am physically fit and have sufficiently trained for the competition and that my date of birth is as stated on this application. I authorize meet personnel and its agents permission to request emergency medical treatment or care as necessary to insure my well being. I agree not to cover or alter my competitor number in any way on pain of disqualification, and I acknowledge that my entry fee is non- refundable, including if the event is canceled. Signature:   Date:

Prior to sealing the envelope and sending in your application, please make sure that you have:

• Completed all information
• Signed the application
• Enclosed your check for the total entry fee ($35 for the first event, $15 for each additional event, $60 for the pentathlon) and and Masters Committee Surcharge of $5. After March 12, a late fee of $10 per event (or pentathlon) must be added. There will be no refunds of entry fees for any reason.
• Made your check payable to USATF-New England, US funds only and drawn on a US bank.
• And ... to assist with media information and help the meet announcer, all athletes are invited to enclose a separate sheet with their notable performances.

Mail application with entry fee to:
National Masters Indoor Championships
USATF-NE, P.O. Box 1905, Brookline, MA 02446.

The street address is: 2001 Beacon Street, Suite 207, Brighton, MA 02135-7787.