Embed Size (px)
Citation preview
2009 CLINIC REGISTRATION FORM
PLEASE INDICATE TEE SHIRT SIZE:
S M L XL XXL
CIRCLE STYLE REQUESTED:
Short Sleeve Navy or Grey
Sleeveless Tee Navy or Grey
For more information on clinic contact :
BOB AMOS 723-616-6758
EMAIL: [email protected]
Registration Forms Due Date:
March 9,2009
*Limited Space Available!
Call for availabilty after March 9, 2009
MAKE CHECKS PAYABLE TO:
T.R.N. Boys Track and Field $65.00
SEND REGISTRATION FORM
AND PAYMENT TO:
T.R.N. Boys Track and Field
Shelley Licknack
33 Swain Avenue
Toms River, NJ 08755 BENNETT INDOOR COMPLEX
TOMS RIVER, NJ
ALL - AMERICANCLINICIANS
TOMS RIVERTRACK & FIELD
CLINICPresented by Bob Amos
TOMS RIVERTRACK & FIELD
CLINICPresented by Bob Amos
MARCH 21, 200910 AM - 3 PM
POLE VAULT
BOB AMOSJump Coach Toms River North Coached 6 Group IV State ChampsCoached 4 All - AmericansPersonal Best 15’3”
CHRIS MAZZA2-Time High School All -American4-Time New England Champion4-Tims Big East ChampionPersonal Best 17’2”
LONG JUMP/TRIPLE JUMP
NORM TATEUSA Olympic Team Member (Triple Jump)Former American Record Holder (Triple Jump)7-Time USA National Team MemberPersonal Best 55’ 11” TJ / 27’ 1 1/4” LJ
JAVELIN
DAVE WIRTHMIKE JUSKUS
2-Time NCAA Champion 1980 - 19815th in Olympic Trials4-Time All - American Personal Best 273’ 3”
ALL- AMERICAN CLINICIANS
HURDLES(New to program this year)
JACK PIERCE1992 Barcellona Bronze MedalistU.S. National ChampionPenn Relay MVP3-Time All-AmericanIn Top 10 for 11 YearsPersonal Best 12.94
HIGH JUMP
MIKE PASCUZZO3-Time USA Olympic Trials4-Time US National Team Member2-Time ACC ChampionPersonal Best of 7’5 1/4”
MIDDLE DISTANCE& DISTANCE
RINGO ADAMSON2-Time Olympic Team Member (Jamaica)6-Time World Cross-Country Team Member8-Time All-American (Glassboro State)New Jersey State Coach of the Year - Indoor
SHOT PUT
JOE NAPOLIHigh School All-AmericanMid-Atlantic Chairman NationalThrows Coaches AssociationPersonal Best 57’ 11”
ALL- AMERICAN CLINICIANS 2009 CLINIC REGISTRATIONFORM
Registration Fee $65.00
NAME
ADDRESS
CITY & STATE ZIP CODE
AGE GRADE MALE FEMALE
(MANDATORY, PLEASE PRINT)
EVENT (S) Studenets may participate in 1 or 2 events only
HIGH JUMP POLE VAULT SHOT PUT
LONG/TRIPLE JUMP JAVELIN
HURDLES MIDDLE/ DISTANCE
PARENTAL CONSENT WAIVER:I herby grant permission for my son or daughterto attend the “Toms River Track and Field Clinic”.I verify that my child has had a physical exam inthe past year and is able to participate in the activi-ties related to the clinic. I agree to indemnify,holdharmless and defend Toms River Regional School District, all camp clinicians & staff, all camp sponsors and /or their agents or employees from any and all liability for injury to my child. Should medical treatment for my child be necessary,I herebyauthorize any physician or trainer selected by camppersonnel to roder and conduct medical or surgicalprocedures necessary.
Parent or Guardian Signature:
