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Belton Stadium Vault Registration
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Email
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First Name
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Your answer
Last Name
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Your answer
Address
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City
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Your answer
State
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Zip Code
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Phone Number (XXX) XXX-XXXX
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Your answer
DOB
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MM
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DD
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YYYY
Gender
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Male
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T-Shirt Size
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S
M
L
XL
XXL
Club
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USATF #
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Your answer
Lifetime PR
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Choose
Less than 6'0
6'0"
6'3"
6'6"
6'9"
7'0"
7'6
7'9
8'0
8'3
8'6
8'9
9'0
9'3
9'6
9'9
10'
10'3
10'6
10'9
11'0
11'3
11'6
11'9
12'0
12'3
12'6
12'9
13'0
13'6
14'0
14'6
15'0
15'6
16'0
16'6
17'0
17'6
18'0
18'6
19'0
19'6
Recent PR (last 6 months)
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Choose
Less than 6'0
6'0"
6'3"
6'6"
6'9"
7'0"
7'6
7'9
8'0
8'3
8'6
8'9
9'0
9'3
9'6
9'9
10'
10'3
10'6
10'9
11'0
11'3
11'6
11'9
12'0
12'3
12'6
12'9
13'0
13'6
14'0
14'6
15'0
15'6
16'0
16'6
17'0
17'6
18'0
18'6
19'0
19'6
Preferred Starting Height
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Choose
Less than 6'0
6'0"
6'3"
6'6"
6'9"
7'0"
7'6
7'9
8'0
8'3
8'6
8'9
9'0
9'3
9'6
9'9
10'
10'3
10'6
10'9
11'0
11'3
11'6
11'9
12'0
12'3
12'6
12'9
13'0
13'6
14'0
14'6
15'0
15'6
16'0
16'6
17'0
17'6
18'0
18'6
19'0
19'6
Waiver
I voluntarily agree to participate in the June 16, 2023 Belton Stadium Vault (BSV) and knowingly assume any and all risks of loss, damage to my person or property, injury (including death), both foreseen and unforeseen, as a result of my attendance at and participation in June 3, 2023 BSV and knowingly, from any cause whatsoever, including the fault or negligence of Releasees (as defined below). I, for myself, my heirs, personal representatives and assigns do hereby release, waive, discharge and covenant not to sue the Meet Administrators and Officials, the Facility, their respective officers, directors, employees, agents and volunteers (collectively "Releasees") from all liability, loss, claims, demands, possible causes of action, court costs, settlement costs and fees, attorneys fees and any other expenses arising from any claim or lawsuit that may arise from any loss, damage or injury (including death) to me or my property resulting from or arising in connection with, or related to, my attendance at or participation in the June 3, 2023 BSV and knowingly. In the event that I am injured, I hereby consent to the provision of necessary and appropriate emergency medical treatment provided by the track meet hosting organization.
By entering this competition, I grant the June 3, 2023 BSV and knowingly a limited license to use my name, likeness, image, voice, video, athletic performance, biographical and other information, in any format whatsoever, and to distribute, broadcast and exhibit these without charge, restriction or liability, but only for the purposes of advertising or promoting the sport of Pole Vaulting and/or Athletics. In no event, however, will such usage constitute an endorsement of any product or service without my specific written consent.
By marking yes that means you have read, understand and agree to the waiver below, with regards to yourself and/or to the minor athlete that you are registering for.
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