Record Application for Race Directors

GEORGIA (only) Road Race Record Application Form

Part I: General Information

Race: Name________________________________

Distance______________________km/miles Date____/___/20___

Location: City______________________________ State_____________

Last year's race name____________________1st year held____________

Personnel: Your name___________________________________________

Email (or Telephone)_____________________________________________

Director's name_________________________________________________

Race Office Telephone___________________________________________

Email__________________________________________________________

Web site_______________________________________________________

Address_______________________________________________________

City__________________________________State____________________

Numbers: Male Entrants_________________Female Entrants__________

Part II: The Course

***I, the undersigned, hereby attest that the race identified in Part I above was

run on the course as described on the USATF Course Measurement Certificate

# ______________________________.

In the event that a record needs to be validated, the following evidence is available

______photograph of start ______photograph of finish

______photograph of turnaround ______video tape of____________

______recording of race numbers at appropriate points

______photograph or other data indicating wind direction

***Signed _______________________________________________Race Director

Part III: Timing and Scoring

Timing System

Type/make of primary timing system______________________________________

(Note that Chip NET times are not official but Chip GUN times are acceptable;

however, both must be submitted.)

Winning times

Time of men's winner __________________ Signature of timer_________________

Time of women's winner________________ Signature of timer_________________

The times recorded above are accurate:

***Signed _____________________________________________Chief Timer

Non-winning times for other individuals in case of record or notable performances:

Name of athlete_______________________Age___Date of birth__________Time_________

(Citizenship if applicable)

Multiple loops

Did the course consist of multiple loops on the road? ___yes ___no

If yes, indicate the length of a single loop _____________km/miles

Copies of lap sheets must be submitted for individuals suspected of record or notable

performances.

Part IV: Bona Fide Competition

I, the undersigned, being the duly appointed referee for the above described race, hereby attest that

a. the start was fair;

*** b. the course was monitored to prevent COURSE CUTTING and to the best of my knowledge all

official finishers ran the course AS CERTIFIED;

*** c. the standards of bona fide competition were in effect and that all award winners competed

fairly WITHOUT ASSISTANCE.

***Signed__________________________________________Race Director (or Referee)

Part V: Results

The complete results with ages and hometowns have been emailed to results@usatf.org

AND a hard copy mailed to Joyce Hodges-Hite, P.O. Box 717, Millen, Ga. 30442. New email address: hodgeshitej@gmail.com