Date _3/5/2006_________ GPHXO Club Member? _Yes____

Entry Name _Jane Doe_______________________________

(C)omp / (R)ec R____    Course ____Red Classic_____

Man        Woman  X   Team        Team Size ______________

Age/Class M40__   USOF# __________   Club ____________

Emergency Phone (123) 456-7890__ Vehicle ID 123 ABC___

Email Address _jane.doe@example.com_________________

Entry $____4_________
Compass $___________
Whistle $_____________
Dues $_______________
Other $______________

TOTAL $____4______

Please Print Clearly.  List all team members.






Jane Doe

1 2nd St.;  Phoenix, AZ


(456) 789-0123

















WAIVER: (Every participant must sign; parent/guardian for anyone less than 18 years) I, the undersigned, know that Orienteering, as an outdoor action sport, carries significant risk of personal injury. I know that there are natural and man-made hazards, environmental conditions, and risks that, in combination with my actions, can cause me serious, or possibly even fatal, injury.  I agree that I, as a participant, must take an active role in understanding and accepting these risks, conditions, and hazards.  I also agree that I, and not the organizers and officials of this event, the US Orienteering Federation, the land owners or managers, or any sponsors, am responsible for my safety while I participate in this event.


_________Jane Doe _____________________________________________      __________________________________________________________



_____________________________________________________________    ___________________________________________________________



Date (required):  Write today’s date here.


GPHXO Club Member (required):  If you are a GPHXO club member, write “Yes;” otherwise, write “No.”


Entry Name (required):  Write a name to appear in the published meet results.  This may be your name, a team name, or a pseudonym.


(C)omp/(R)ec (required):  If you are entering recreationally, write “R.”  If you are entering competitively, enter “C.”  If you are competitive, the club will publish your time in the newsletter; otherwise, the club will not publish your time.


Course (required):  Write the name of the course you are participating in today.  Check the setter’s notes for a list of courses.


Man/Woman/Team (required):  Indicate with a checkmark if you are a man, woman, or a team.


Team Size (optional):  If you are a team, write the number of team members; otherwise, leave this field blank.


Age/Class (optional):  If you are competitive, write your age class; otherwise, leave this field blank.  Check the setter’s notes for a list of classes.


USOF# (optional):  If you are a member of the United States Orienteering Federation (USOF), write your member number; otherwise, leave this field blank.


Club (optional):  If you are a member of another orienteering club, write the name of your club.


Emergency Phone (required):  Write a phone number to call in case of an emergency.


Vehicle ID (required):  Write the license plate number of your vehicle.  If you forget to check in with the timer’s table, the club will look for your vehicle before starting a search for you on the course.


Email Address (optional):  Write your email address.  The club will use this for occasional messages about club events and never sells or shares your email address.


Team member list (optional): List each member of your team.  Be sure to indicate if each member has a whistle.  Every team member must have a whistle.


Waiver (required):  Read the waiver and sign below.  Every team member must sign.  If you are under 18 years of age, a parent or guardian must sign.


For registrar (required):  If you are the club registrar (not the participant), complete this section and record the amount paid for course entry and, if applicable, a compass, a whistle, and dues.  If the participant purchases other items, like a t-shirt or mug, record the payment here, too.