DeKalb County

DEKALB COUNTY
SENIOR OLYMPICS INFORMATION
DeKalb County Senior Olympics Purpose:
To provide adults 50 and older an opportunity to participate in events that:
- Encourage more physical activities
- Promote healthier lifestyles
- Promote health and wellness
- Provide a unique opportunity for socialization through competitive activities.
Age
Participants must be 50 years old by September 26, 2012. Events are divided into men and women divisions
and into age groups where appropriate. Birthdate must be included for this reason.
Awards
Gold, Silver and Bronze medals will be awarded to 1st, 2nd and 3rd place winners in each event.
DeKalb County Senior Olympics reserves the right to combine age groups or to cancel any event due to
insufficient registration, inclement weather, and unusual or extenuating circumstances.
REGISTRATION AND FEES
A $10 registration fee must accompany the completed application form.
Registration for participants outside of DeKalb County will be an additional $20.
A $5 late registration fee will be added after April 20.
Mail-in registrations must be postmarked by April 20.
Registration includes a Senior Olympics T-shirt.
Participants are limited to two events only.
Mail registration form with payment to:
DeKalb County Recreation, Parks & Cultural Affairs
Attn: Anya Shepherd
1300 Commerce Drive, Suite 300
Decatur, Georgia 30030
Registration is payable by check or money order; NO CASH ACCEPTED
Please make payable to DeKalb County Recreation, Parks & Cultural Affairs
The liability waiver must be signed and dated by the applicant.
Special accommodations will only be available with prior arrangements. If you need special assistance, please let
us know when you register.
For additional information, call 404-687-2751.
2012 DeKalb County Senior Olympics Events Schedule
TUESDAY, MAY 1st (OPENING DAY)
FREE
10:00 a.m.
FREE
11:00 a.m.
1:00 p.m.
Opening Ceremony
& Torch Run
Health Expo & Registration
Check-in
Wii Bowling
Porter Sanford III Performing Arts
& Community Center (PSPACC)
PSPACC
(Atrium/Lobby)
PSPACC (Black Box Theatre)
3181 Rainbow Dr
Decatur, GA 30034
WEDNESDAY, MAY 2nd
10:00 a.m.
Swimming
Beulah Family Life Center
2340 Clifton Spring Rd
Decatur, GA 30034
THURSDAY, MAY 3rd
10:00 a.m.
Free Throw Basketball
10:00 a.m.
3-on-3
Exchange Recreation Center
2771 Columbia Dr
Decatur, GA 30034
FRIDAY, MAY 4th
8:00 a.m.
Golf
Sugar Creek Golf & Tennis Center
2706 Bouldercrest Rd
Atlanta, GA 30316
SATURDAY, MAY 5th
9:00 a.m.
Track & Field
9:00 a.m.
Horseshoes
Panthersville Stadium
2817 Clifton Springs Rd
Decatur, GA 30034
MONDAY, MAY 7th
9:00 a.m.
Tennis
( Singles & Doubles)
Exchange Recreation Center
2771 Columbia Dr
Decatur, GA 30034
TUESDAY, MAY 8th
1:00 p.m.
Water Volleyball
Beulah Family Life Center
6:00 p.m.
Table Tennis (Singles)
Ebster Recreation Center
(Decatur Active Living)
2340 Clifton Spring Rd
Decatur, GA 30034
404 W. Trinity Pl
Decatur 30030
WEDNESDAY, MAY 9th
12 noon
Billiards
Twains Billiards & Tap
211 E. Trinity Pl
Decatur, GA 30030
THURSDAY, MAY 10th
1:00 p.m.
Adm.
$5
7:00 p.m.
Bowling
Suburban Bowling Lanes
2619 N. Decatur Rd
Decatur, GA 30030
Line Dancing Competition *
Porter Sanford III Performing Arts
& Community Center
3181 Rainbow Dr
Decatur, GA 30034
FRIDAY, MAY 11th (CLOSING CEREMONY)
Adm.
$8
10:00 a.m.
Talent Show
& Closing Ceremony **
Porter Sanford III Performing Arts
& Community Center
* Line Dancing
Admission - $5 per person / Group Registration - $30 per team
** Closing Ceremony - $8 for all non-paid participants and/or guests.
3181 Rainbow Dr
Decatur, GA 30034
2012 SENIOR OLYMPICS REGISTRATION FORM
Complete form and mail to: DeKalb County Recreation, Parks & Cultural Affairs
1300 Commerce Drive, Suite 300, Decatur, GA 30030
Name:
Facility/Organization:
Participant Status:
New
Returning
Address:
City:
State:
Age:
Date of Birth:
Daytime Phone:
/
Zip:
/
Sex :
Male
Female
Email Address:
Emergency Contact:
Relationship:
Emergency Phone:
Shirt Size
Medium
Large
X Large
XX Large ($2 extra)
XXX Large ($2 extra)
REGISTRATION DEADLINE: April 20th. Late registration will be accepted after April 20th with an
additional $5 late fee. Fees are non-refundable.
PARTICIPATION FEES
√
FEE
ACTIVITY/EVENT
Registration for two events only
(This fee excludes golf & bowling events)
Non-Residence Fee
$20.00
$37.00
Golf Tournament (include green fees and cart)
Guest at Closing Ceremony Event Fee
$ 8.00
Bowling (additional fee)
$ 9.00
Additional fee for t-shirt sizes XXL - XXXL
$ 2.00
TOTAL
Registration is payable by check or money order; NO CASH ACCEPTED
Make payable to: DeKalb County Recreation, Parks & Cultural Affairs
$10.00
Registration forms and payments can be mailed to or dropped off at the following location:
DeKalb County Recreation, Parks & Cultural Affairs
Attn: Anya Shepherd
1300 Commerce Drive, Suite 300
Decatur, Georgia 30030
For additional information, call 404-687-2751 or visit www.dekalbcountyga.gov/parks.
WAIVER/RELEASE
I indemnify and hold harmless DeKalb County and/or the DeKalb County Recreation, Parks and Cultural Affairs, the organizers
of the activity, sponsors, hosting facilities and its employees, supervisors, and any and all of them, all of which are hereinafter
referred to as “releasee”, from and against all claims, damages, actions, judgments, decrees, penalties, and/or liability and
expenses in connection with loss of life, bodily and/or personal injury caused or alleged to be caused in whole or in part by the
negligence of the releaser or otherwise. I have prepared myself for the events which I have entered by practicing prior to the
games. To the best of my knowledge and belief, I have no physical restrictions which should prohibit my participation in the
games. I have read the above waiver/release, and understand that I have given up substantial rights by signing it and I sign it
voluntarily.
Signature ___________________________________________
Date __________________________________
Please check the events you would like to compete in.
PARTNER/TEAM
EVENTS
EVENTS
TABLE TENNIS (Doubles)
TABLE GAMES
 TABLE TENNIS
 BILLIARDS
Partner’s Name: ____________________________
Age: _____50+_____55+_____60+____65+____70+_____75+
TENNIS (Doubles)
Partner’s
Name:___________________________
Age:
_____50+_____55+_____60+____65+____70+_____75+
WATER VOLLEYBALL
Team Name ________________________________________
_______Co-ed
________All Females ________ All Males
Group Age:
______50+______55+_______60+______65+______70+_____75+
SPORTS
 GOLF (Shot Gun Format)
 CLOCK GOLF
 TENNIS (singles)
 HORSESHOES
 BOWLING
 Wii BOWLING
 FREE THROW BASKETBALL
SWIMMING:
Please check one division:

Recreational Division (novice or hobby)

Competitive Division (leagues or teams)




3-ON-3 BASKETBALL


Team Name: _________________________________________
Roster:
Name
__________________________________
__________________________________
__________________________________
Age
_____
_____
_____
TALENT SHOW
Participant/Groups Name:_______________________
Type of Entertainment:_________________________
Age:________

50 M FREESTYLE
100 M FREESTYLE
50 M BREAST STROKE
100 M BREAST STROKE
50 M BACKSTROKE
50 M BUTTERFLY
100 M BUTTERFLY
TRACK AND FIELD
 SHOT PUT
 SOFTBALL THROW
 FOOTBALL TOSS
 DISC
 LONG JUMP
 25 Y DASH
 50 Y DASH
 220 Y DASH
 ½ M WALK
 1M WALK
_____TIMED
_____FUN (Free Event)
Applications may be picked up from the following locations:
DeKalb County Recreation, Parks and Cultural Affairs
Administrative Office
1300 Commerce Dr., Suite 300
Decatur, GA 30030
All DeKalb County Public Libraries
Austin Drive Senior Campus
1989 Austin Dr
Decatur, GA 30034
Beulah Family Life Center
2340 Clifton Springs Rd
Decatur, GA 30034
Suburban Bowling Lane
2619 N. Decatur Rd
Decatur, GA 30030
Sugar Creek Golf & Tennis Center
2706 Bouldercrest
Atlanta, GA 30316
Twains Billiards & Tap
211 E. Trinity Pl
Decatur, GA 30030
Lou Walker Senior Center
2538 Panola Rd
Lithonia, GA 30038
Decatur Active Living (Ebster Recreation Center)
404 W. Trinity Pl
Decatur, GA 30030
Porter Sanford III Performing Arts Center
3181 Rainbow Dr
Decatur, GA 30034
DEKALB COUNTY RECREATION CENTERS
Briarwood
2335 Briarwood Way
Atlanta, GA 30319
Browns Mill
5101 Browns Mill Rd
Lithonia, GA 30038
Exchange
2771 Columbia Dr
Decatur, GA 30034
Gresham
3113 Gresham Rd
Atlanta, GA 30316
Hamilton
3263 Chapel St
Scottdale, GA 30079
Lucious Sanders
2484 Bruce St
Lithonia, GA 30058
Lynwood
3360 Osborne Rd
Atlanta, GA 30316
N. H. Scott
2230 Tilson Rd
Decatur, GA 30032
Mason Mill
1340-B McConnell Dr
Decatur, GA 30033
Midway
3181 Midway Rd
Decatur, GA 30032
Redan
1839 Phillips Rd
Lithonia, GA 30058
Tobie Grant
644 Parkdale Dr
Scottdale, GA 30079
Tucker
4898 LaVista Rd
Tucker, GA 30084