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Name ^(required)

Age ^(required)

Date of Birth ^(required)

Male/Female ^(required)

Athlete's Email ^(required)

Confirm Athlete's Email ^(required)

Cell Phone Number ^(required)

USATF Member Number ^(required)
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Street Address ^(required)

City ^(required)

State ^(required)

Zip Code ^(required)

Emergency Contact #1 ^(required)

Emergency Contact #1 Relationship ^(required)

Emergency Contact #1 Cell Number ^(required)

Emergency Contact #2

Emergency Contact #2 Relationship

Emergency Contact #2 Cell Number

Your Personal Best ^(required)

Approximate Starting Height ^(required)

Optional Pole Vault Bio, Highlights, Championships, Etc. List Here:

Referral Code

Are You Over 18? ^(required)

Guardian's Name ^(required)

Guardian's Relationship ^(required)

Guardian's Number ^(required)

Guardian's Email ^(required)

I HAVE READ THE ATTACHED WAIVER AND RELEASE OF LIABILITY AND ASSUMPTION OF RISK ACKNOWLEDGEMENT AND AGREE AND UNDERSTAND. I ALSO UNDERSTAND THAT I WILL BE REQUIRED TO SIGN THIS DOCUMENT ON THE DAY OF THE EVENT BEFORE BEING ALLOWED TO COMPETE. IN THE CASE OF COMPETITORS UNDER THE AGE OF 18 THE PARENT OR GUARDIAN MUST SIGN.
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