Registration Form
2004 United States Interscholastic Orienteering Championship,    April 16-18, 2004

Information:  Register on or before March 31, 2004 on a first-come, first-serve basis.  Changes and cancellations are permitted until March 31, 2004, after which refunds will be considered on an individual basis.  All Interscholastic participants must be USOF members.  Fees include USOF member discount. Interscholastic entrants must enter BOTH Saturday and Sunday. Friday event is optional.
Instructions:  One form must be completed for each participant.  Please clearly print all infomation, sign the waiver, make check payable to "Orienteering Cincinnati" and mail to: Vince Hand, 511 East Chestnut St, Oxford, OH  45056

Name of entrant_____________________________________________    Year of birth_________     Sex: M__  F__     Club__________

Street Address_____________________________________________________________    Telephone (_______)________-_________

City_______________________________  State______  Zip Code_____________  E-mail_____________________________________

USOF Membership Number (Membership in USOF is required in order to register and compete)__________________________________

SportIdent Electronic Punch Card:    Rent?_______    Own?________     SI Number if owned ____________________________________

School Name______________________________________________  Coach / Instructor Name__________________________________

Coach / Instructor Phone (_______)________-___________  Coach E-mail__________________________________________________

Days entered:    Friday (short course) ______________          Saturday and Sunday (U.S. Interscholastic Championship)______________
 
If you are running as part of a team, check both your INDIVIDUAL and TEAM class in the table.  If you are running only as an individual, check your individual class and leave team information blank.  You must run the same class on all days you enter.
Middle School High School Junior Varsity High School Varsity
Individual Classes MS-Male____ MS-Fem.____ HSJV-Male____ HSJV-Fem.____ HSV-Male____ HSV-Fem.____
Team Classes MS-Team____ HSJV-Team____ HSV-Team____

Team Name___________________________________________  Other Team Members ____________________________________

____________________________________________________________________________________________________________

Event Fees    $15 per day of competition (postmark before March 1, 2004)
                    $20 per day of competition (postmark March 1 - March 31, 2004)          __________.00

Electronic Punch Card Rental $5    (mandatory if you do not own an SI Card)            __________.00

T-Shirt    $15 each    S___    M___    L___    XL___    XXL___                                   __________.00

Preview Maps    $5 each    WT___    GH___    MSRA____                                        __________.00

Dinners    Friday _____ @ $5    Saturday _____ @ $7                                              __________.00

Total amount payable to Orienteering Cincinnati (OCIN)                                      _____________.00

WAIVER OF RESPONSIBILITY
I, the undersigned, know that Orienteering, as an outdoor action sport, carries significant risk of personal injury.  I know that there are natural and man-made hazards, environmental conditions, and risks which, in combination with my actions can cause me serious, or possibly even fatal, injury.  I agree that I, as a participant, must take an active role in understanding and accepting these risks, conditions, and hazards.  I also agree that I, and not the organizers and officials of this event, the US Orienteering Federation, the land owners or managers, or any sponsors, am responsible for my safety while I participate in this event.

Name (please print) _________________________________________    Signature ___________________________________________

Date________________  Parent or guardian must sign if entrant is under 18 _________________________________________________

 

 

Be sure that you have:
      clearly printed all infomation,
      signed the waiver,
      enclosed a check payable to "Orienteering Cincinnati" or "OCIN"
      and mailed to: Vince Hand, 511 East Chestnut St, Oxford, OH  45056
Questions?  E-mail the registrar at PigReg@ocin.org

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updated 2345 11/25/2003