NEBRASKA ASSOCIATION
		 USA TRACK & FIELD

INDIVIDUAL ENTRY FORM FOR YOUTH MEETS


NAME OF MEET ___________________________________________

LAST NAME __________________________________

FIRST NAME __________________________________

CLUB NAME ________________________ or UNATTACHED ______

GIRL ___________ or BOY __________

FULL DATE OF BIRTH   ______ / ______ / 19______

EVENT #1 & Seed Mark (Required, please put N/A if 1st time doing event) ______________

EVENT #2 & Seed Mark (Required, please put N/A if 1st time doing event) ______________

EVENT #3 & Seed Mark (Required, please put N/A if 1st time doing event) ______________

EVENT #4 & Seed Mark (Required, please put N/A if 1st time doing event) ______________ 
(Youth, Intermediate, and Young Men/Women only)

Name and address of family sending the form:

__________________________________________________________________________________

Phone: __________________________  (REQUIRED)



E-mail address: __________________________________________________________________

PAYMENT MUST BE SENT WITH FORM OR ENTRY WILL NOT BE PROCESSED, NO EXCEPTIONS.