The 2012 Virgin Islands Track and Field Federation ATHLETE Registration Form
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The Virgin Islands Track & Field Federation
ATHLETE Registration Form 2012)
To register for and remain in good standing with The Virgin Islands Track and Field Federation you are required to complete all the following questions on this the VITFF registration form. Upon completion of this registration form, you are required to pay the annual $25.00 (ages 14 and under pay $10.00) VITFF registration fee. This information and a scanned digital color copy of your Passport must be submitted to the VITFF (see mailing address and email address below) for approval. Upon approval you will then receive your official VITFF Registration Number and Registration Card. You will then will be eligible for VITFF, Virgin Islands Olympic Committee and International Association of Athletics Federations benefits and privileges.
1
. Your Status for 2012
Your Status for 2012
New Registration:
Registration Renewal:
2
. Please provide accuarate personal information:
Please provide accuarate personal information:
Last Name:
Middle Name:
First Name:
Passport Number:
Passport Issue Date:
Passport Expiration Date:
Where was your Passport issued(you are required to provide a scanned color copy of your passport to the VITFF with this registration):
What is your place of birth?
What is your mother's place of birth?
What is your father's place of birth?
Mailing Address/City:
State:
Country:
Zip Code:
Home Address/City:
State:
Country:
Zip Code:
Home Telephone Number:
Work Telephone Number:
Cell Telephone Number:
Fax Number:
Email Address:
Website Address:
*
3
. Where is your place of birth?
Where is your place of birth?
*
4
. Where is your mother's place of birth?
Where is your mother's place of birth?
*
5
. Where is your father's place of birth?
Where is your father's place of birth?
*
6
. Sex:
Sex:
Male:
Female:
7
. What is your age?
What is your age?
8
. What is your date of birth: [DD/MM/YYYY ie. 01/10/1988]
What is your date of birth: [DD/MM/YYYY ie. 01/10/1988]
*
9
. Are you a United States Citzen:
Are you a United States Citzen:
Yes:
No:
10
. If you are NOT a United States Citizen, what is your country of citizenship:
If you are NOT a United States Citizen, what is your country of citizenship:
11
. If you are not a United States Citizen and live in the United States, what is your official Status (you are required to provide a copy of your official documentation to the VITFF along with this registration?
If you are not a United States Citizen and live in the United States, what is your official Status (you are required to provide a copy of your official documentation to the VITFF along with this registration?
12
. If you are a member of a club,what is the name of your club?
What is the VITFF number of your Club: (If you are not a member of a club, enter N/A on each line...
If you are a member of a club,what is the name of your club? What is the VITFF number of your Club: (If you are not a member of a club, enter N/A on each line...
Club Name:
Club Number:
13
. Please check the appropriate sport code:
Please check the appropriate sport code:
Track
Field
Road Running/Long Distance Running
Cross-Country Running
Ultra-Marathon Running
Mountain/Trail Running
Race Walking
14
. If you are a student athlete, what school do you attend:
If you are a student athlete, what school do you attend:
15
. If you are student/athlete, What is your coach's name, phone number, email address? If you are a club athlete, what is your coach's name, phone number, email address?
If you are student/athlete, What is your coach's name, phone number, email address? If you are a club athlete, what is your coach's name, phone number, email address?
School/Club:
Coach's Name:
Coach's Phone Number:
Coach's Email Address:
16
. If you are a professional athlete:
If you are a professional athlete:
What is your club/organization?
Who is your agent?
17
. Please provide contact information for:
Your agent:
Your club/organization:
Please provide contact information for: Your agent: Your club/organization:
18
. What is your main event/s...Best performance...Date of performance
What is your main event/s...Best performance...Date of performance
Event 1.
Event 2.
Event 3.
Event 4.
Event 5.
19
. Have you competed in an International Association of Athletics Federations championships for a country other than the U.S. Virgin Islands? If Yes, when, what event?
Have you competed in an International Association of Athletics Federations championships for a country other than the U.S. Virgin Islands? If Yes, when, what event?
20
. Do you have medical insurance:
Do you have medical insurance:
YES:
NO:
21
. Please provide the name of your insurance company
and type of coverage:
NOTE: By completing the registration, paying the annual registration fee, you
will establish good standing and insurance coverage (in addition to coverage you
may or may not have with your own insurace) when traveling to and from
specific IAAF competitions.
Please provide the name of your insurance company and type of coverage: NOTE: By completing the registration, paying the annual registration fee, you will establish good standing and insurance coverage (in addition to coverage you may or may not have with your own insurace) when traveling to and from specific IAAF competitions.
*
22
. Have you ever tested positive for WADA listed drugs or recreational/illegal drugs?
Have you ever tested positive for WADA listed drugs or recreational/illegal drugs?
YES:
NO:
23
. If you answered yes to question #16, please provide details here:
If you answered yes to question #16, please provide details here:
*
24
. Have you ever been convicted of a crime?
Have you ever been convicted of a crime?
YES:
NO:
25
. If you answered yes to question #18 please provide details here:
If you answered yes to question #18 please provide details here:
26
. To be eligible for a Virgin Islands Track & Field National Team, athletes, coaches, officials, volunteers are required to complete this form and meet applicable criteria.
The annual registration fee is $25.00 (ages 14 and under pay $10.00)
Please send your payment by mail to:
The Virgin Islands Track and Field Federation
P.O. Box 223094
Christiansted, St. Croix,
Virgin Islands 00822
To Pay online, logon to: http://virginislandstrackandfield.org
Please email passport-size photograph to: isv@mf.iaaf.org
Please email color copy of your passport to: isv@mf.iaaf.org
By registering with the VITFF you are supporting the development of track and field in the Virgin Islands. The Virgin Islands Track and Field Federation is a non-profit organization affiliated with The International Federation of Athletic Federations, The Virgin Islands Olympic Committee, the North America, Central America and Caribbean Athletics Confederation and the Central America and Caribbean Athletics Confederation...
Please share in a few words, your goals and objectives in track and field...
To be eligible for a Virgin Islands Track & Field National Team, athletes, coaches, officials, volunteers are required to complete this form and meet applicable criteria. The annual registration fee is $25.00 (ages 14 and under pay $10.00) Please send your payment by mail to: The Virgin Islands Track and Field Federation P.O. Box 223094 Christiansted, St. Croix, Virgin Islands 00822 To Pay online, logon to: http://virginislandstrackandfield.org Please email passport-size photograph to: isv@mf.iaaf.org Please email color copy of your passport to: isv@mf.iaaf.org By registering with the VITFF you are supporting the development of track and field in the Virgin Islands. The Virgin Islands Track and Field Federation is a non-profit organization affiliated with The International Federation of Athletic Federations, The Virgin Islands Olympic Committee, the North America, Central America and Caribbean Athletics Confederation and the Central America and Caribbean Athletics Confederation... Please share in a few words, your goals and objectives in track and field...
27
. Now that you have registered with the Virgin Islands Track and Field Federation, once it has been determined that you are eligible and qualified for a V.I. National Track and Field Team, you will be issued a V.I. National Team Uniform provided by Mizuno the sponsor for V.I. Track and Field. Please proved the requested information listed below.
The Mizuno uniforms are sized according to Japanese sizes, if you received a uniform for 2010, please provide sizes according to that uniform, otherwise, please be careful to provide USA sizes and make sure that you allow for accurate fitness:
Now that you have registered with the Virgin Islands Track and Field Federation, once it has been determined that you are eligible and qualified for a V.I. National Track and Field Team, you will be issued a V.I. National Team Uniform provided by Mizuno the sponsor for V.I. Track and Field. Please proved the requested information listed below. The Mizuno uniforms are sized according to Japanese sizes, if you received a uniform for 2010, please provide sizes according to that uniform, otherwise, please be careful to provide USA sizes and make sure that you allow for accurate fitness:
1. Training Shoe Size
2. Competition shoe size
3. Competition top size (chest size)
4. Competition shorts size (waist size)
5. Tee-Shirt size (chest size)
4. Warm-up Jacket (chest size)
5. Warm-up pants size (waist size, leg length)
6. Tight size
7. Your height
8. Your weight
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