BRITISH MASTERS ATHLETIC FEDERATION

Application for British Masters Age-Group Record or "Best Performance"
TRACK OR ROAD EVENTS

To: Bob Minting, Chairman Records & Statistics Sub Committee
The Rowans, Convent Road, Sidmouth, Devon EX10 8RD

Application is hereby made for a British Masters Age-Group Record in support of which the following information is submitted. (Please type or use Capitals throughout)

EVENT......................................... OUTDOOR/INDOOR.................PERFORMANCE.............................

FULL NAME OF COMPETITOR.................................................................... MALE/FEMALE................
ADDRESS...................................................................... ........................................................................
....................................................................................... ........................................................................
AGE GROUP................................................... DATE OF BIRTH..........................................................
MEETING DATE............................................... STADIUM NAME.........................................................
TOWN............................................................. COUNTY/COUNTRY....................................................

RESULT OF RACE
The names of the first three competitors and their times were as follows:
1st............................................................................... Time...................................
2nd.............................................................................. Time...................................
3rd............................................................................... Time...................................
If not in first 3 - Position.............................................. Time...................................

STARTERS CERTIFICATE
I hereby certify that the start of the race was in accordance with I.A.A.F. Rules
Name of Starter.............................................................. Signature...................................Grade........

TIMEKEEPERS CERTIFICATE (HAND TIMING)
I, the undersigned official Timekeeper of the race, hereby certify that the time set opposite my signature was the exact time recorded by my watch and that the watch used by me has been certified
Time..........................Name............................................ Signature...................................Grade........
Time..........................Name............................................ Signature...................................Grade........
Time..........................Name............................................ Signature...................................Grade........

CHIEF TIMEKEEPER
I confirm that the above Timekeepers exhibited their watches to me and that the times were as stated
Name of Chief Timekeeper ........................................... Signature....................................Grade........

ELECTRICAL TIMING
A Fully automatic electrical timing device was used. The time recorded was..............................
Name of Chief Photo-Finish Judge................................ Signature.................................

WIND GAUGE
I hereby certify that the wind speed in direction of running was........................................m/sec
Name of operator.......................................................... Signature....................................

TRACK REFEREE
I hereby certify that the above performance was achieved in a bona fide competition held in accordance with the appropriate IAAF rules. I further certify that the barriers were at a height of ................... (hurdles and steeplechase only).
Name............................................................................ Signature.....................................Grade............