World Eskimo-Indian Olympics

2012 Athletic Competition Application


Name:

(first name)
  
(last name)
 
Social Security Number: ––     Sex:
male
female
 
Age:     Date of Birth:
(month)
 /
(day)
 /
(year)
 
Address:
 
(Street)

(City)
  
(State)
(& Country if not U.S.)
  
(ZIP/Postal Code)
 
Email Address:
 
Phone #1:     Phone #2:     Fax #:

Registration
Is this your first time at WEIO? yes no
If not, how many years have you participated in WEIO?

Check the events you will participate in.

FISH CUTTING
SEAL SKINNING
RACE OF THE TORCH
ESKIMO STICK PULL
INDIAN STICK PULL
4 MAN CARRY
DROP THE BOMB
EAR PULL
EAR WEIGHT
TOE KICK
KNEEL JUMP
1 FOOT HIGH KICK
2 FOOT HIGH KICK
1 HAND REACH
BENCH REACH
ALASKA HIGH KICK
GREASED POLE WALK
BLANKET TOSS
KNUCKLE HOP
ARM PULL
MUKTUK EATING

Blanket toss preliminaries will be limited to ten contestants for men and ten contestants for women with top five from each competing in finals. Top three from last year’s blanket toss finals will have priority if competing.

Waiver of Responsibility

By providing my confirmation below, I agree to the following: In consideration of my application to register in the events marked above, I, on behalf of any heir, executor, or administrator I may have after the execution of my signature, hereby waive and release any and all claims for damages I may have against World Eskimo-Indian Olympics, Inc. (hereinafter referred to as “WEIO”), and any other sponsoring/organizing organization of clinics, qualifying preliminary, regional or final competition, their agents or representatives, for any and all injuries sustained by me in the WEIO or in any activity, including transportation to and from such aforementioned competition, related directly or indirectly to my participation. I hereby grant permission, without compensation to and from WEIO or its appointees to use my name and image taken during the WEIO in any promotional material or advertising. I understand that knowledge of the rules and regulations of WEIO are my responsibility.

PLEASE NOTE: Minimum age for participation in any event is 12 years old. Both the registrant and parent/guardian, if the registrant is under the age of eighteen (18), must provide confirmation signifying their understanding of these waiver clauses. Failure to do so may lead to nonparticipation.
I, the registrant, have read and understand the above.
I, the parent/legal guardian of the registrant, have read and understand the above.

Registration Fees

The registration fee for athletic events is $25.00

Upon submititng this form you will be redirected to fee processing.