2013 Michigan Short Track

2015 Michigan Short Track Speedskating Championships Saturday, February 21, 2015 Sanctioned by the Michigan Speedskating Association Sponsored by West Michigan Speedskating Club Location: Eagles Ice Center Check in: 9:00 am - 10:00 am 2600 Village Drive SE Warm-Ups begin at 10:00 am Grand Rapids, MI 49506 Racing begins at 10:45 am 616-574-5700 Skating until 6:00 pm. Awards at 6:15 pm.

Rink Size: NHL (85 × 200 meters) Required Equipment: Long sleeve shirt, helmet, neck protector, gloves, and shin guards The race schedule will be per ISU age requirements and may be changed at the direction of the sponsor or officials. Awards: 1st-4th by age division and gender Entry Fee: $35 per skater ($70 maximum per family) Make checks payable to: Michigan Speedskating Association Registration Deadline: Wednesday, February 18, 2015. NO LATE ENTRIES! Submit registration to: Mark Jastrzembski email: [email protected] 2179 Lake Ave. phone: (231) 828-4627 Twin Lake, MI 49457 ***All skaters must be current registered members of MSA and US Speedskating Meet Director: Mark Jastrzembski (231) 828-4627 [email protected] Lodging: A special rate is available at the following hotels: Hilton – Grand Rapids Airport - $92.00 + tax 4747 28th St SE, Grand Rapids, MI 49512 616-957-0100 (Must say “State Games” when calling for discount) https://resweb.passkey.com/go/wintergames

------Return bottom portion with payment ------Release Form: 2015 Michigan Short Track State Championships on February 21, 2015 In consideration of the acceptance of my entry in the above event, I hereby waive, release and discharge any and all claims for damages for death, personal injury or property damage which may have, or which any hereafter occur to me as a result of my participation in said event. This release is intended to discharge in advance the West Michigan Speedskating Club, Eagles Ice Center, West Michigan Sports Commission, Michigan Speedskating Association, US Speedskating and any municipalities or other public entities and their respective agents and employees from and against any and all liability arising out of or connected in any way with my participation in said event, even though the liability arises out of the negligence on the part of the persons or entities mentioned above. It is further understood and agreed that this waiver, release and assumption of the risk is to be binding on my heirs and assigns. Applicant's Signature Parent/Guardian Signature (if under age 18) Date ______Name______Gender______Birth Date ____/____/______Class______Age as of 7/01/2014______Seed Time 500M (Midget And Up)______333M (Pony And Younger)______Address______City______State______Zip______Phone Number (______)______Email______Club affiliation ______US Speedskating #______