Please bring this half sheet to practice or mail it to the high school with

your payment (payable to Columbus High School).

2011
_________________________________________________________
STUDENT’S NAME: ___________________________

STUDENT’S GRADE: ___________________________

PRACTICE: April 18th @ 6:00-7:15 pm TRACK MEET: May 16th @ 5:00-9:00 pm STUDENT’S SCHOOL: __________________________
April 25th @ 6:00-7:15 pm
May 2nd @ 6:00-7:15 pm
May 9th @ 6:00-7:15 pm WHERE: Columbus High School Track1
EMERGENCY CONTACT: _________________________
EVENTS: 60 Meter Dash COST: $20
60 Meter Low Hurdles2
100 Meter Dash EMERGENCY PHONE NUMBER: _______________________
200 Meter Dash DETAILS: Four practices
400 Meter Dash One track meet
800 Meter Run Age appropriate heats and flights
1600 Meter Run3 Ribbons for the top six STUDENT’S SHIRT SIZE: Youth Small Adult Small
One t-shirt (Please circle your choice)
Long Jump Youth Medium Adult Medium
High Jump
Shot Put AGES: K-6th Youth Large Adult Large
Discus Throw
Adult X-Large
CONTACT:
I/We ______________________________________,
Patrick Clark allow our son/daughter to participate in the Columbus High School Track Clinic and Meet. I/We
Columbus High School do not hold Columbus Public Schools or Camp instructors responsible for any injuries that may
2200 26th Street occur while participating.
(402) 563-7050
patrick.clark@cps-ne.org

1
Signature of parent or guardian: ___________________________
If weather is bad, practice will be in the North Gym at the High School
2
Hurdles will be run in the grass, Kindergarteners will not hurdle, 1st-3rd=24”, 4th-6th=30”
3
Kindergarten will not run the mile Date: ______________________________________