BRITISH MASTERS ATHLETIC FEDERATION

Application for British Masters Age-Group Record
FIELD EVENT

To: Bob Minting, Chairman Records & Statistics Sub Committee
The Rowans, Convent Road, Sidmouth, Devon EX10 8RD

Application is hereby made for a British Masters Age-Group Record in support of which the following information is submitted: (Please type or use Capitals throughout)

EVENT..................................OUTDOOR/INDOOR........... PERFORMANCE....................
FULL NAME OF COMPETITOR............................MALE/FEMALE......
ADDRESS............................................................................
............................................................................................
AGE GROUP................... DATE OF BIRTH...........................

MEETING DATE...............................................................................
STADIUM NAME..............................................................................
TOWN.............................................................................................
COUNTY/COUNTRY.........................................................................

EQUIPMENT OFFICERS CERTIFICATE
I hereby certify that the equipment used in the record claimed has been examined by me after the performance and conforms exactly with the relevant IAAF Rule except as modified by WAVA by-laws(Appendix A) for veterans competition. I further certify that the implement weighed...................
Name.................................................... Signature..........................................Grade........

FIELD JUDGES CERTIFICATE
We hereby certify that the performance given above was achieved in competition according to the appropriate IAAF rules and was measured in accordance with IAAF Rule 148 Paragraph 11(a).
Name.................................................... Signature..........................................Grade.........
Name.................................................... Signature..........................................Grade.........
Name.................................................... Signature..........................................Grade.........

WIND GAUGE OPERATORS CERTIFICATE (Long & Triple jump only)
I hereby certify that the wind speed in the direction of jumping was ....................................metres/sec.
Name.................................................... Signature..........................................Grade.........

FIELD REFEREES CERTIFICATE
I hereby certify that the above performance was achieved in a bona fide competition held in accordance with the appropriate IAAF rules
Name.................................................... Signature..........................................Grade.........

RESULT OF COMPETITION
The names of the first three competitors and their performances were as follows:

1st................................................. Performance........................

2nd................................................ Performance........................

3rd................................................. Performance........................

If not in first 3 Position..................... Performance........................

NOTE: A COPY OF THE RESULTS CARD MUST BE INCLUDED WITH THIS APPLICATION