Kentucky Association of USATF

/ USATF
Officials Certification
Association Level – National Level
Master Level
Gordon Bocock, Kentucky Certification Chair /

Clinic Registration

Name / Home Phone / Cell Phone
Address / E-Mail Address
Years Officiating Track / Check the level you are working toward
USATF Officials Certification Number / Association / National / Master
# 0
USATF National Membership Number
Mark your areas
Below
/ Track and Field Officiating has many different and varied venues.
Association Level Officials can only select 6 areas of specialty
National and Master Levels should limit to 10 areas of specialty
Mark you choices as 1, 2, 3 etc in order of your desires / Mark your areas
Below

Track Events / Field Events / Other USATF Skills
1 / Referee – Running Events / 15 / Referee – Field Events / 29 / Referee – Multi Events
2 / Chief Finish Judge / 16 / Chief Field Judge / 30 / Referee – LDR & XC
3 / Chief Timer / 17 / Discus / 31 / Referee – Race Walk
4 / Chief Umpire / 18 / Shot Put / 32 / Multi Events Coordinator
5 / Finish Line Coordinator / 19 / Hammer/Weight / 33 / Race Walk Judge
6 / Chief Lap Scorer / 20 / Javelin / 34 / LDR/XC Timer or Recorder
7 / Chief Photo Evaluator / 21 / Long Jump / 35 / LDR General
8 / Fully Automatic Time / 22 / Triple Jump / 36 / Marshal
9 / Computer Entry/Results / 23 / High Jump / 37 / Athletics for the Disabled
10 / Starter / 24 / Pole Vault / 38 / Wind Gauge Operator
11 / Clerk of the Course / 25 / Weights & Measures / 39 / Race Walk Official
12 / Finish Judge or Finish Timer / 26 / Technical Manager / 40 / Competition Secretary
13 / Umpire / 27 / Field Event Palm Pilots
14 / Lap Scorer / 28 / Electronic Measurements

CLINIC FEE - $25.00 . . . . . Make check payable to – Ky. USATF Officials

USATF Track & Field seeks to promote increased diversity in officiating and will use the following information to monitor the progress.
Which of the following best describes your ethnicity?
Asian / Caucasian / Native American
African American / Latino/Hispanic / Pacific Islands
Are you a KHSAA Official for the 2007 – 2008 School Year / Yes / No / KHSAA Official Registration #

All forms are to be e-mailed to or mailed to Gordon Bocock, 101 Owens Ferry Road, Somerset, Kentucky 42503

Signature ______