WORLD (WMA) Application for a Combined Event Record

The completed application and supporting documents must be submitted to the Regional Records Chair after the IAAF or WMA Masters Member of the athlete has certified the record. This record application must be accompanied by a Birth Certification as proof of age, if not previously submitted, a Zero Test image for each day, a Photo Finish image for each track event, a copy of the judge’s score sheet for each field event, the wind measurements and the complete results of the event.

EVENT: Throws ____ Indoor Pentathlon ____ Outdoor Pentathlon ____ ____ ____

Record Claimed (Points): ______

Date: Day ___ Month ___ Year_____ City: ______Country: ______

Name of Stadium/Facility: ______

Name of Competition: ______

ATHLETE: Printed Full Name: ______Male ___ Female ___

Country of athlete: ______Date of Birth: Day ___ Month ___ Year______Age on day of record:______

Implement Certification: I certify that I inspected the implement(s) used for the claimed record and the implement(s) conforms exactly to the specifications in the WMA Rules of Competition that were in effect on the day of the performance.

Printed Name: ______Signature: ______

Fully Automatic Timing: The make of the timing device: ______

Chief Photo Finish Judge: Printed Name: ______Signature: ______

Guarantee by Technical Delegate or Referee or Meet Director: I certify that all information recorded on this form is accurate, that the officials/judges conducting the events were qualified and that all appropriate IAAF Rules of Competition, as modified by WMA, were complied with.

Printed Name: ______

Signature: ______Date: ______

The following MUST be enclosed with this application for a WMA World Record: • The Zero Test image for each day of competition • The Photo Finish image for each track event • The copy of the Judges Score Sheet for each field event • The Wind Measurement (if applicable) • The Official Results of the event • A copy of the athlete’s Birth Certificate as proof of age (if not previously submitted)

WMA Combined Event Record Form 2019 SP