2023 USARS TRACK AND ROAD CHAMPIONSHIPS AND TEAM USA TRIALS-REGISTRATION FORM

2023 USARS TRACK AND ROAD CHAMPIONSHIPS AND TEAM USA TRIALS-REGISTRATION FORM
Please click here more for event information and the Team USA Selection criteria

Deadline to enter will be July 31

NO LATE ENTRIES WILL BE ACCEPTED.

Pan Am Games - These championships will also be the trials for the 2023 Pan American Games.

Please refer to the 2023 Pan American Games Selection Procedures.
Name*

First NameLast Name
Email*
example@example.com
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number*
Please enter a valid phone number.
DOB*

MonthDayYear
Date
AGE AS OF JANUARY 1, 2023*
GENDER*
USARS MEMBER ID NUMBER*
CURRENT USARS CLUB*
TRACK CHAMPIONSHIPS

Primary Division – 7 and underJuvenile Division – 8-10 years of ageFreshman Division – 11-13 years of ageJunior Division– 14-18 years of ageJunior World Class – 14-18 years of ageSenior Division- 14 years or olderSenior World Class – 14 years or olderMasters Division
If entering into Masters please select your age division

25-3435-4445-5455 and up
ROAD CHAMPIONSHIPS

Primary Division – 7 and underJuvenile Division – 8-10 years of ageFreshman Division – 11-13 years of ageJunior Division– 14-18 years of ageJunior World Class – 14-18 years of ageSenior Division- 14 years or olderSenior World Class – 14 years or olderMasters Division
If entering into Masters please select your age division

25-3435-4445-5455 and up

My Products

Junior and Senior World Class Banked Track

$85.00

Junior and Senior World Class Road

$85.00

Primary, Juvenile, Freshman, Junior, Senior, Masters Track

$70.00

Primary, Juvenile, Freshman, Junior, Senior, Masters Road

$70.00

Total

$0.00

IMPORTANT: By submitting this application, I am acknowledging I am a member in good standing and eligible to participate in the championships. A member in good standing has completed Safe Sport training (18+), is in good financial standing with USA Roller Sports and willing to complete a background check (18+). I understand that if I am selected as a Team USA Member for the World Speed Championships, I must participate in all training which may include a residency program and other prescribed activities. I also agree to meet all departure times, dates and flights as arranged by the USARS National Office, the Team Coach and/or Team Manager. I further understand as a member of the USA World Team, I will be responsible for timely deposits, payments, and documentation to the USARS National Office. Failure to adhere to the specified deadlines may jeopardize my ability to participate as a member of Team USA
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