First Annual Rodeo Pole Vault Clinic - DOC

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First Annual Rodeo Pole Vault Clinic - DOC Powered By Docstoc
					                                    Staff:
    th
10 Annual “Rodeo”                       Roy D. Willits, Coach Mt.           Athlete Name:
                                         View, Tucson (17 years).
Pole Vault Clinic                       J. Croissant, Coach Salpointe
                                         CHS, Tucson (10 years)
When: Saturday February 20,                                                  Age:__________/Year in School:_______
                                        Other staff may include: James
2010, 8:30am-4:30pm.
                                         Truitt, CDO, and other local        Address:___________________________
Where: Canyon Del Oro HS.                coaches.
Canyon del Oro High School                                                   __________________________________
                                    Equipment:
25 W. Calle Concordia, Tucson, AZ
                                    Athletes need to bring appropriate       Phone Number:_____________
85737.
Just west of Rte. 77/Oracle Road.   workout clothes (dress warm!), running
                                    shoes and spikes, poles if at all        High School/Coach:__________________
Who: All vaulters or potential      possible. We will provide water, pole
vaulters, age 10 and over, any      vault pits, some poles, and other        Height/Weight:___________/__________
level of experience.                equipment for vaulting drills.
                                                                             Number of Years Vaulting: 0 1 2 3+
Cost: $40 for registrations         Schedule:
postmarked by 2/5 or called in by         8:30 Registration                  Current PR:_______________
2/6 (Wednesday), $50 for late or          9:00 Vault Session
walk-in registration.                     12:00-1:30 Lunch                   Fill out this form, and sign the   back,
                                          1:30-4:30 Vault Session            and send with checks payable to
Lunch IS included. Contact us for                                            Pole Pilots Track Club:
team discounts.                     pole pilots track club
                                    R. D. Willits, J. Croissant.             pole pilots track club
http://www.polepilots.org           Contact us at: 520-206-9322              R. D. Willits, J. Croissant.
                                    (voicemail), or jlc@u.arizona.edu.       1137 E. Edison Street
                                    1137 E. Edison Street                    Tucson, AZ 85719
                                    Tucson, AZ 85719
Camps are an invaluable way to learn                                                       I hereby grant permission for myself/child to
                                                                                           attend the Pole Pilots Pole Vault Clinics. I
the pole vault. In a focused
environment surrounded by other
                                            pole pilots track club                         verify that I/my child had a physical exam in
                                                                                           the last year and am/is capable of participating
vaulters, you can really learn the event    Roy D. Willits, J. Croissant.                  in the activities related to pole vaulting. I agree
effectively.                                Contact us at: 520-206-9322                    to indemnify, hold harmless, and defend Jen
                                            (voicemail), or jlc@u.arizona.edu.             Croissant, Roy D. Willits, Jr., Pole Pilots, CDO
                                            1137 E. Edison Street                          High School, USAT&F, their agents,
We at Pole Pilots are committed to safe
                                            Tucson, AZ 85719                               employees, and sponsors from any and all
instruction in vaulting fundamentals,                                                      liability for injury to myself/child. I understand
and to providing techniques and                                                            that track and field and in particular pole
strategies for long-term success in this,   We are Tucson’s only pole vaulting             vaulting and many of its related activities are
and other track and field events.           club! Recent alumni include:                   potentially dangerous and could pose risk of
                                                                                           injury. Should medical attention be necessary,
Besides clinics we hold regular                                                            I hereby authorize any physician or trainer
                                            Connie Jerz, Tucson High 2000
workouts for our vaulters. Contact us                                                      selected by club personnel to conduct medical,
                                            5A State Champ, former 5A State Record
for more information!                       (12’2-1/2”). USATF Jr. All-American, U of A,   first aid, or surgical procedures.
                                            2003 NCAA Outdoor Runner Up, PR 14’1-1/2”
                                                                                           I have read and understood, and I agree with
                                            Colin Witter-Tilton, Ironwood Ridge 2006       the informed consent and release outlined
Support your local Pole Vaulters:                                                          above as it relates to myself/son/daughter.
                                            4A State Champ, PR of 16’1, now jumping at
http://www.polepilots.org                   the University of Oregon.

                                            Caitlin Clancy, CDO 2006,                      Participant’s
                                            4A State Champ, PR of 12’, now jumping at      signature:________________________
                                            the University of Tulsa.
                                                                                           Date:___________________
                                            Martin Nevarez, Casa Grande HS 2006
                                            5A State Champ, PR of 15’7, now jumpin gat
                                            Casa Grande Community College.                 Parent/Guardian’s
                                                                                           signature:________________________
                                            Erin Anderson, Mountain View 2001. PR of
                                            13’3 at the University of Arkansas, formerly
                                                                                           Date:___________________
                                            NJCAA Champ for Paradise Valley CC with a
                                            PR of 12’7 and a 4A HS state Champ with a PR
                                            of 12’1.

				
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