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Registration
Form for the
2008
Centre County Senior Games
June
3 - 25, 2008 - For
ages 50 & up!
Where applicable the
following age categories will be used:
50-59, 60-64, 65-69,70-74,75-79, 80-84, 85-89,
90+
$5
Registration fee includes T-shirt, any events, & luncheon
Deadline
for registration: May 23, 2008
NAME:
_______________________ ____________________ _________
last first middle initial
ADDRESS:__________________________________________________
____________________________________________________________
MUNICIPALITY______________________ PHONE:
___________________
BIRTHDATE______________ AGE
(on May 3, 2008) _______
Gender:
M _____F_____ T-shirt Size: ❒S ❒M ❒L ❒XL ❒XXL
June 25th AWARDS LUNCHEON #53910 (sponsored by the Centre County Office of Aging):
I will attend lunch at Mt. Nittany Middle School: ____YES ____NO
#53911- Number of guests @ $1.00 =____
The
luncheon for Senior Games participants is included with the
$5 Entry Fee. Please include an additional $1.00 for each luncheon
guest, along with your registration fee (payable to "CRPR").
Senior
Center patrons not participating in any events should register for the June
25 luncheon at their respective center.
EVENTS (please
check those you wish to enter)
☐ REGISTRATION
☐ AWARDS LUNCHEON
☐ AWARDS LUNCHEON GUEST
☐ BSKTBALL. HOTSHOT
☐ BOCCE
☐ BOWLING Philipsburg*
☐ BOWLING Millheim*
☐ BOWLING Bellefonte*
☐ BOWLING Northland *
☐ WATER VOLLEYBALL
☐ SOFTBALL THROW
☐ TABLE TENNIS
☐ 1 MILE WALK (outdoor)
☐ 1 MILE WALK (indoor)
☐ GOLF (9 hole)
☐ GOLF (18 hole) |
#53901
#53910
#53911
#53912
#53940
#53913
#53914
#53915
#53916
#53921
#53928
#53919
#53920
#53930
#53917
#53918 |
*If
you will be bowling at more than one site, circle where
your score will count.
RELEASE & WAIVER
OF LIABILITY
To
the best of my knowledge, information and belief, I have
no physical restrictions which would prohibit my participation
in the events that I have entered in the Centre County Senior
Games. I have prepared
myself for the event(s) entered by practicing prior to the
Senior Games; I am participating in these events voluntarily
and at my own risk; I agree to release and hold-harmless
from all liability the Centre County Senior Games Committee,
CRPR, and the Centre Region Senior Center, as well as any
other sponsoring organizations and any of their representatives
or volunteers for any injury or damages to me as a result
of my participation in the 2008 Centre County Senior Games.
SIGNATURE________________________ DATE:____________________
THE
CENTRE COUNTY SENIOR GAMES COMMITTEE STRONGLY RECOMMENDS
THAT EACH PARTICIPANT CONSULT A DOCTOR IN REGARD TO PRACTICE,
PREPARATION AND COMPETITION IN THIS PROGRAM OR SIMILAR ACTIVITIES.
Please
print and submit with a $5 registration fee plus any luncheon
guest fees to:
CENTRE
REGION SENIOR CENTER, 131
S. Fraser St. #1,
State College, PA 16801
OR REGISTER ON-LINE (Note that a Convenience Fee will be added to the Senior Games Fee).
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