Pine Tree State Track and Field Games Commitment Form

This form is for the 2019 MRPA Regional Track meet.
Please return to Deb Smith no later than June 19, 2019.

Name of the department wishes to participate in the MRPA Regional Track and Field Meet.
Please Check which regional meet you will be participating in:
- Northern Maine – at Caribou High School- TBA
- Central Maine – at Cameron Stadium, Bangor - Date TBA
- Southern Maine – at South Portland High School - TBA
Estimated Number of participants for the 2019 Regional T & F meet (Include all 9-14 year olds as of December 31, 2019)
Contact Person: (This is where registration and information will be sent)
Name*
First Last
Title
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Phone (home)
Phone (work)
Email*
Track Coach Information: (If this is different than above please provide this information)
Name
First Last
Email
Phone (home)
Phone (work)
This form must be completed and received by June 19, 2019.

Contact Person: (This is where registration and information will be sent)