registration book - San Diego Senior Games Association

2013 CALIFORNIA SENIOR GAMES
CHAMPIONSHIPS
HOSTED BY SAN DIEGO SENIOR OLYMPICS
30+ competitive sports for men and women age 50+
REGISTRATION BOOK
AUGUST 24 – OCTOBER 5, 2013
Archery, Badminton, Basketball, Billiards, Bowling, Darts, Golf, Handball, Horseshoes,
Lawn Games, Paddleball, Pickleball, Racquetball, Soccer, Softball, Swimming,
Table Tennis, Tennis, Track & Field, Volleyball, and more!
We Encourage Online Registration! www.sdseniorgames.org
It is easy to register and your confirmation is immediate.
San Diego Senior Games Association
4740 Murphy Canyon Road Suite #200
San Diego CA 92123
858-292-5812 (office) 858-292-5216 (fax)
www.sdseniorgames.org
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2013 California Senior Games Championships
BOARD OF DIRECTORS
San Diego Senior Games
Association
ANNE ROSSER
Chair and Education Committee
JIM CAMPBELL
Vice Chair
BRIAN LIVESAY
Treasurer
MISSION STATEMENT
WELCOME
The San Diego Senior Games
Association (SDSGA) is a California
non-profit corporation committed to
encour aging adults, age 50 and over,
to carry on vigorous lives by developing
and maintaining adequate personal
physical fitness through regular
participation in recreational activities,
sports, physical fitness activities and
educational programs.
On behalf of the Board of Directors of the
San Diego Senior Games Association,
it gives me great pleasure to
welcome you to the 2013 California
Senior Games Championships. For the
years 2013 and 2014, The San Diego
Senior Olympics will be the California
Senior
Games
Championships.
Although 2013 is a non-qualifying
year, the top finishers in 2014 will
qualify for the National Senior
Games in Minneapolis, Minnesota in
2015.
KAREN BROOKFIELD
Games
This event is one of the largest senior
sports festivals held in California and
we are proud to host these games
each year. Our participants range in
age from 50 to 97 and we have
developed a new Prime Time Division
allowing ages 40-49 to participate in
several sports. We host 32 sports of
which 19 are National sports and the
rest are considered local sports.
JILL SPITZER
Secretary &
Volunteer Committee
BLAINE PHIPPS
Legal Counsel
KIRBY WOHLANDER
BRENDAN R. MCMURTRIE
SHASHIN VORA
EX-OFFICIO BOARD MEMBERS
Dr. Mel Gregory
Roger Martin
Len Sonnenberg
Dr. Lee Rice
STAFF
KAREN BROOKFIELD
Office Director & Games Commissioner
DANNY PROPP
Director of Community Relations
BOB WEBB
Business Consultant
GAME HEADQUARTERS
SDSGA
4740 Murphy Canyon Road #200
San Diego, CA 92123
1-858-292-5812
www.sdseniorgames.org
GOALS
• Improve and maintain health and
wellness of senior adults 50+
• Focus attention on the importance
of regular exercise and constructive
activity
• Celebrate the vitality of life
through example and create an
awareness of opportunities that
promote a healthy lifestyle
• Provide competitive athletic and
recreational experience at Local,
State, and National levels.
The participants are to be commended
for their commitment, training, and
practice, which is necessary to excel
at any level of competition in their
selected sport or sports. We appreciate
the athletes returning each year to
support their sports and our
organization.
The Commissioners of all 32 sports
and the many volunteers who make
these games possible are to be
recognized for their many hours of
service and labor, always making
sure each event is organized.
Finally, it is the support and belief in
us by our sponsors that have made
the 2013 California Senior Games
Championships a reality.
To All of You, Thank You for Your
Continued Support and Enjoy the
Games!
ANNE ROSSER
Chairman of the Board
San Diego Senior Olympics • 4740 Murphy Canyon Road #200 • San Diego, CA 92123 ~ 858-292-5812 • E-mail: [email protected] • www.sdseniorgames.org
INFORMATION
HOW TO REGISTER
REGISTRATION & FEES
ONLINE
There are three types of fees:
Go to www.sdseniorgames.org beginning June 1, 2013
to register online. You can register a team or yourself for
individual sports. You may make payment with a credit
card or send a check. You will receive a confirmation letter
to the email address given.
MAIL IN
Complete the registration form in this booklet and mail to:
SDSGA attn: Registration
4740 Murphy Canyon Road #200
San Diego, CA 92123
You can also visit our website at: www.sdseniorgames.org
to download and print the registration forms.
You can also call us at 1-858-292-5812 to request a
registration form.
Payment must be made by check, money order, cashier’s
check, OR credit card. SDSGA cannot be responsible for
lost or misdirected mail. If you don’t receive a conformation
letter in a timely manner, please call the office.
COME TO THE OFFICE
We will be able to help you register online at the office.
Please call ahead so we make sure a registration volunteer
is available.
We will also hold registration events at different times
and places during the months of July and August. See
website for details.
Event Fee, and Team Fee.
Registration Fee,
The Registration Fee for each individual participant
covers the administrative costs of the games including
rent, salary, utilities, insurance, medals, t-shirts, lunches,
and printing. The CSGA dues are also paid with this fee.
Event Fees for specific activities and competitions
cover the actual cost of that particular sport including
venue costs, deposits, permits, equipment, and officials.
Team Fees cover all players participating on a team. If
you are playing on a team, you are not required to pay a
separate Registration Fee unless you are participating in
another sport.
All registrants will receive a t-shirt, lunch (sandwich,
orange, banana, & a bottle of water) and have the option to
purchase additional lunches if your sport runs for
multiple days.
REFUND POLICY
All refund, cancellation, and change requests for
Emergency Event changes must be made three weeks
before competition of that sport event and is subject to a
$10.00 processing fee.
All requests must be in writing and submitted to the
SDSGA office. SDSGA reserves the right to deny any
refund request or may make exceptions to deadline based
on special circumstances. To request an exception to the
deadline, (extenuating circumstances) athlete must
submit a Refund Request with a reason for request in
writing within one week after competition of that sport
event. Applicable refunds will be issued following the
Games.
Phone calls will not be accepted as official cancellation
requests. It is the responsibility of the athlete to ensure
that SDSGA has received individual requests.
No refunds will be given due to event conflicts for
multi-sport entrants.
San Diego Senior Olympics • 4740 Murphy Canyon Road #200 • San Diego, CA 92123 ~ 858-292-5812 • E-mail: [email protected] • www.sdseniorgames.org
INFORMATION
AGE FOR COMPETITION
TEAM REGISTRATION
Participants will register according to their age as of
December 31, 2013. Age categories for both men and
women are 50-54; 55-59; 60-64; 65-69; 70-74; 75-79;
80-84; 85-89; 90-94; 95+ and 100+.
Team Manager or Captain will register a team online by
entering all team members. To enter the team a manager
must enter member full name, birthday, email, and
t-shirt size. Each member will receive an email with a
link to sign a waiver.
Age categories for doubles and teams will be determined
by the youngest player as of December 31, 2013.
Swimming age is determined by day of event.
Some sports will offer a “Prime Time” Division with the
ages of 40-44 and 45-49. This division will have separate
medals and t-shirts and are not considered a part of the
California Senior Games Championships.
For the teams which mail in their registration, all team
members must be included on the roster with each
member’s full name, birthday, email, and t-shirt size. If
signed waivers are included in the packet, then the
Manager will receive a confirmation of entry. If waivers
are not included, then each member will receive an email
with a link to sign a waiver. All players are required to
register individually after the team is registered.
AWARDS
Gold, Silver, and Bronze medals will be awarded in all
events, for each gender, for all age divisions. Medals will
be given at the end of events or after the final competition.
Medals will not be mailed unless it is the fault of SDSGA.
EQUIPMENT
PARTNERS
Participants are required to provide their own equipment
for the events entered (except as specified under the
sport description). Please be sure to mark your personal
items and do not leave valuables unattended. SDSGA is
not responsible for the loss or damage of any athlete’s
personal equipment.
A partner should be indicated on the registration form by
full name. During online registration a partner can be
selected from a list of “needing a partner”. The
Commissioner will assign a partner if one is requested as
long as there are players on the “needing a partner”
list of the same age group.
You may only participate with one doubles and one
mixed doubles partner per event.
The age of the youngest partner will determine the age
category. All partner changes must be made one week
before competition so partners are set and partner
changes are not allowed on site.
San Diego Senior Olympics • 4740 Murphy Canyon Road #200 • San Diego, CA 92123 ~ 858-292-5812 • E-mail: [email protected] • www.sdseniorgames.org
INFORMATION
UNIFORMS
EVENT CANCELLATION
All athletes must wear the appropriate athletic-type
clothing and shoes for the sport(s) in which they are
competing. Team sports require like color and style
numbered uniforms.
In the event of inclement weather or unusual, extenuating
circumstances, Games Officials, or SDSGA Board of
Directors or Games Commissioner reserve the right to
cancel outdoor events.
Clothing, shoes, or equipment that are inappropriate or in
violation of the sport’s rules will be cause for
disqualification. The SDSGA Sport Commissioners have
been authorized to make this determination. If you have
any questions, please contact the Commissioner.
During the Games, call your Commissioner or Games
information at (858) 292-5812 or check the website if the
weather looks uncertain.
SPORTSMANSHIP/CONDUCT
Unsportsmanlike or disorderly conduct on the part of
competitors or coaches will be grounds for immediate
removal and disqualification from competition without
any refund of fees paid. Sports Commissioners and/or
SDSGA staff reserve the right to disqualify any competitor
for these grounds.
There will be no refunds for events cancelled due to
weather, war, or an act of God. The SDSGA also reserves
the right to cancel any event due to insufficient entries
and also reserves the right to combine age divisions.
Cancellations due to insufficient entries will be given
refunds.
MEDICAL ASSISTANCE
SDSGA will make an attempt to have qualified athletic
trainers and/or medical personnel on site. If you must be
transported by ambulance, it will be at your expense.
INSURANCE
The SDSGA has a General Liability Insurance Policy for
the Games. It is expressly understood that this insurance
does not cover property loss, damage to the participant,
or medical costs if an accident or injury occurs during the
normal routine of competition or during travel to and
from the competition.
Each participant is responsible for his or her own
medical insurance. Prior to competition, each athlete
MUST SIGN a waiver, or the athlete will not be eligible to
participate.
LUNCH
OPENING CEREMONIES
Athletes will be allowed to order 2 tickets to the Opening
Ceremonies, but there is a limit of 200 tickets available.
This Celebration of the Athlete will be held at the Hall of
Champions in Balboa Park on September 6, 2013 from
6:00pm – 8:00pm.
Each athlete will be provided with a free lunch from
Capriotti’s (a new sponsor). Athletes will have the
opportunity to order additional lunches for sports being
played on multiple days.
San Diego Senior Olympics • 4740 Murphy Canyon Road #200 • San Diego, CA 92123 ~ 858-292-5812 • E-mail: [email protected] • www.sdseniorgames.org
2013 Registration Form FOR OFFICE USE ONLY
Date Rec’d _________
Check No. __________
Check Amt. _________
COMPLETE ALL INFORMATION (PLEASE PRINT CLEARLY) & PLEASE SIGN WAIVER FIRST NAME: ________________ LAST NAME: ______________________ MI: ______ STREET ADDRESS: _________________________________________________________ CITY: ____________________________ STATE: ________ ZIP CODE: ______________ HOME PHONE: (____) _____________________ CELL: (____) _____________________ BIRTH DATE (mm/dd/yyyy): ________________________ AGE as of 12/31/13: _______ EMAIL ADDRESS: _____________________________________ GENDER (M/F): _______ (SDSGA does not sell participant email addresses and only distributes to sponsors) checks payable to: Make SDSGA Mail Entry Form, Waiver & Check for Fees to: SDSGA attn: Registration 4740 Murphy Canyon Road Suite #200 San Diego CA 92123 ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ QUESTIONS Contact the sport’s commissioner shown on the Schedule of Events page or call 858-­‐292-­‐5812 Please Circle T-­‐shirt Size Small X-­‐Large Medium XX-­‐Large Large XXX-­‐Large Opt Out 1 Free Lunch -­‐ choose Turkey____ Veggie_____ Lunch includes a banana, orange & bottle of water Individual Registration $35.00 (Early Bird until 8/04/13) Individual Registration $40.00 ~~~~~ After 8/04/13 ~~~~ Total Event Fees (Fees listed beside sport) Number of Events Entered _______ Number Extra Lunches____ @$5.00 Turkey____ Veggie____ (1st lunch free) Donation to SDSGA Deductible IRS 501(c)(3) Thank You! TOTAL THANK YOU FOR YOUR PARTICIPATION No Refunds on Lunches. If you play multiple sports, pay attention to dates/times before you order multiple lunches. *** WAIVER & CODE OF CONDUCT must be signed and mailed with registration. By registering, you agree to the conditions on the waiver on the next page. Please don’t forget to sign.
EMERGENCY CONTACT INFORMATION Print Name: __________________________________________ Relationship: ________________________ Phone: ( ) ______________ Waiver & Code of Conduct Form ***Required***
PARTICIPANT LIABILITY WAIVER and ACCEPTANCE OF CODE OF CONDUCT Photo & Film Waiver: I hereby grant full permission to the organizers, their agents, employees, and representatives to use my name, voice, and/or picture or film in any broadcast, telecast, advertising, promotion or other use in relation to the San Diego Senior Games Association and the San Diego North County Senior Games. By signing this waiver, I have read and agree to all terms set forth herein. LIABILITY WAIVER: In consideration of being allowed to participate in any way in the San Diego Senior Games Association (SDSGA) program, related events and activities, the undersigned acknowledges, appreciates and agrees that: (1) The risk of injury from the activities involved in these programs is significant, including the potential for permanent disability and death, and while particular rules, equipment, and personal discipline may reduce this risk, the risk of serious injury to me does exist; and, (2) I KNOWINGLY AND FREELY ASSUME ALL SUCH RISKS, both known and unknown, EVEN IF ARISING FROM THE NEGLIGENCE OF THE RELEASEES or others, and assume full responsibility for my participation; and, (3) I willingly agree to comply with the stated and customary terms and conditions for participation. If I observe any unusual significant concern in my readiness for participation and/or in the program itself, I will remove myself from participation and bring such to the attention of the nearest official immediately; and, (4) I, for myself and on behalf of my/our heirs, assigns, personal representatives and next of kin, HEREBY RELEASE THE SDSGA, its officers, officials, agents and/or employees, other participants, sponsoring agencies, sponsors, advertisers, and if applicable, owners and lessors of premises used to conduct the event (“Releasees”), WITH RESPECT TO ANY AND ALL INJURY, DISABILITY, DEATH, or loss or damage to person or property incident to my involvement or participation in these programs, WHETHER ARISING FROM THE NEGLIGENCE OF THE RELEASEES OR OTHERWISE, to the fullest extent permitted by HEREBY INDEMNIFY AND HOLD HARMLESS all the above Releasees from any and all liabilities incident to my involvement or participation in these programs, EVEN IF ARISING FROM THEIR NEGLIGENCE, to the fullest extent permitted by law. I have read this release of liability and assumption of risk agreement, fully understand its terms, that I have given up substantial rights by signing it, and sign it freely and voluntarily without any inducement. By signing this waiver, I have read and agree to all terms of this RELEASE OF LIABILITY. CODE OF CONDUCT: All participants and teams competing in the SDSGA program are expected to act in a sportsmanlike manner consistent with the spirit of fair play and conduct themselves responsibly, as outlined below: 1.
2.
3.
4.
5.
All participants shall treat other participants, volunteers and officials with dignity and respect. All participants shall abide by the rules of their sport, and shall avoid conduct that demeans, harasses, or threatens any person. All participants shall promote honesty and integrity in their statements and actions. All participants shall respect the property of others, whether personal or public. All participants agree that they will not bring alcohol or pets to any SDSGA program or event. If a service animal is required, the participant will provide paperwork to an SDSGA official or designate certifying the animal’s status as a service animal. The Director of SDSGA, or their designate, shall have the complete authority to enforce this Code of Conduct. Any participant or team found to have violated any provision of this Code of Conduct shall be subject to reprimand, suspension or expulsion from the event or games. By signing this waiver, the undersigned has received, read and understood the Code of Conduct and accepts, adopts and agrees to be bound by the same. PRINT NAME: _______________________________________________________ SIGNATURE: ________________________________________________________ DATE: _____________________ I, ___________________________ Name of Parent or Guardian, agree to accompany or have another adult accompany the minor child at all times while they are involved in any activity on the premises, and acknowledge that I am fully and totally responsible for the above child at all times while he/she is participating in any activity held by the SDSGA. Signature of Parent or Legal Guardian __________________________________________ 2013 California Senior Games Championships Registration
Please register for events that are not held at the same time. The Games Management cannot guarantee you will be able
to compete in all events. Please (X) mark the event(s) you wish to enter. (Refer to Schedule of Competition for dates,
time and locations.) Event Fees are listed beside the Sport.
BASKETBALL SKILLS-MEN
Athletes Name – Please Print
TEAM SPORTS








Men’s Basketball (min. age 50) ($180)
Women’s Basketball (min. age 40) ($180)
Men’s softball (min. age 50) ($420)
Women’s Softball (min. age 50) ($420)
Women’s Soccer (55+ and 65+) ($450)
Women’s Soccer (50+ and 60+) ($450)
Men’s Volleyball (min. age 50) ($180)
Women’s Volleyball (min. age 35) ($180)
ARCHERY (minimum age 35)
 American 900 Round
 Basketball Free Throw ($3)
 Hot Shots ($3)
BASKETBALL SKILLS-WOMEN
 Basketball Free Throw ($3)
 Hot Shots ($3)
BILLIARDS (minimum age 40)
 8-Ball Singles ($5)
 9-Ball Singles ($5)
 Scotch Doubles($5)____________________
Partner’s Name
BOARD GAMES (minimum age 40)
 Checkers
 Chinese Checkers
 Scrabble
NAA DIVISIONS:





Compound Release ($10)
Compound Fingers ($10)
Recurve Sighted ($10)
Barebow Recurve ($10)
Barebow Compound ($10)









Freestyle ($10)
Freestyle Limited ($10)
Freestyle Limited Recurve ($10)
Bowhunter ($10)
Bowhunter Freestyle ($10)
Bowhunter Freestyle Limited ($10)
Traditional Recurve ($10)
Traditional Longbow ($10)
Barebow ($10)
 Chess
 Dominoes
BOCCE BALL (minimum age 40)
 Singles ($3)
 Doubles($3)___________________________
Partner’s Name
 Mixed Doubles($3)______________________
Partner’s Name
NFAA DIVISIONS:
BADMINTON (minimum age 40)
 Novice Singles ($5)
 Singles ($5)
 Doubles($5)___________________________
Partner’s Name
 Mixed Doubles($5)______________________
Partner’s Name
BOWLING (minimum age 40)
SCRATCH & MOST OVER AVERAGE



(scores count for both tournaments)
Novice Singles ($10)
Singles ($10)
Doubles($10)__________________________
Partner’s Name
 Mixed Doubles($10)_____________________
Partner’s Name
CYCLING
To be held in Pasadena June 4-5
DARTS (minimum age 35)
 Singles ($5)
 Doubles($5)___________________________
PICKLEBALL (minimum age 50)
~~~~~~
See Pickleball Entry Form ~~~~
Partner’s Name
 Mixed Doubles($5)______________________
Partner’s Name




FITNESS (minimum age 40)
Abdominal Knee Ups
Dips
Sit and Reach
Obstacle Course




Pull Ups
Push Ups
5 Tree Run
Medicine Ball
GOLF (minimum age 40)
RACQUETBALL (minimum age 50)
 Singles ($5)
 Doubles($5)___________________________
Partner’s Name
 Mixed Doubles($5)______________________
Partner’s Name
ROAD RACE RUN / WALK(minimum age 40)
 5K – walk ($5)
 10K – walk ($5)
 Cottonwood Country Club - 18 Holes
(Greens Fee $40)
HANDBALL (minimum age 50)
 Singles ($5)
 Doubles($5)___________________________
Partner’s Name
HORSESHOE PITCHING (minimum age 40)
 Novice Singles
 Singles
 Doubles______________________________
SHOOTING (minimum age 50)
 Air Pistol ($5)
 3-Position ($5)
Partner’s Name




LAWN GAMES (minimum age 40)
Cornhole
 Croquet
Frisbee Toss
 Horseshoe Toss
Ladder Golf
 Washers
Lawn-cathlon (score points on all lawn games)
PADDLEBALL (minimum age 50)
 Singles ($5)
 Doubles($5)___________________________
Partner’s Name
 Mixed Doubles($5)______________________
Partner’s Name
 Air Rifle ($5)
SHUFFLEBOARD (minimum age 40)
 Singles ($3)
 Doubles($3)___________________________
Partner’s Name
 Mixed Doubles($3)______________________
Partner’s Name
SWIMMING (minimum age 50)
Partner’s Name
 Mixed Doubles_________________________
 5K – run ($5)
 10K – run ($5)
~~~~~~
See Swimming Entry Form ~~~~
TABLE TENNIS (minimum age 50)
TENNIS (minimum age 50)
 Novice Singles ($5)
 Singles – 1000+ Rated ($5)
 Doubles($5)___________________________
 Novice Singles ($5)
 Singles ($5)
 Doubles($5)___________________________
 Mixed Doubles($5)______________________
 Mixed Doubles($5)______________________
Partner’s Name
Partner’s Name
Partner’s Name
Partner’s Name
TRACK and FIELD (minimum age 50)
TRACK EVENTS:











50m Dash ($3)
100m Dash ($3)
200m Dash ($3)
400m Dash ($3)
800m Run ($3)
1500m Run ($3)
3000m Run ($3)
1500m Race Walk ($3)
80m/100m High Hurdles ($3)
300m/400m Intermediate Hurdles ($3)
Grandparent/Grandchild Relay ($3)
FIELD EVENTS:








High Jump ($3)
Pole Vault ($3)
Long Jump ($3)
Triple Jump ($3)
Discus Throw ($3)
Javelin Throw ($3)
Shot Put ($3)
Hammer Throw ($3)
REGISTRATION FORM
California Senior Games Championships Pickleball Tournament
Sept 20-22, 2013 at Castle Creek Inn & Country Club, 29850 Circle R Way, Escondido 92026
USAPA Sanctioned, Tier 3
Events: Singles, Women's Doubles, Men's Doubles, Mixed Doubles
Schedule: Sept 20: MS & WD, Sept 21: WS & MD, Sept 22: MXD,
Entry Deadline: Entries must be received two weeks prior to event or late fee of $10 will be assessed.
Entry Fee: Entry Fees are $45 (no event fees). Includes free T-shirt and free box lunch on Friday, Sept. 20 th.
Contact Information: Dennis Dacey (760) 731-2440 or Audrey Phillips (858) 756-3356
Location: Castle Creek Inn & Country Club, 29850 Circle R Way, Escondidio, CA 92026 (I-15 & Gopher Canyon Rd.)
Format of Play: Double elimination. Some events may be merged. Yellow DuraBall will be used.
Mail To:
Dennis Dacey, 1726 Cuadro Vista, San Marcos, CA 92078
If you want free box lunch on Friday indicate TURKEY_______ or VEGETARIAN_______ (also includes orange & banana)
Gender (M or F): ____
Please circle desired T-shirt size: S M L XL XXL
Name:_____________________________________________________________________________
Last
First
middle initial
USAPA Member Number
Address:___________________________________________________________________________
City
State
Zip
Phone #:_____________________ Cell Phone #:__________________ Birth date: _____________
Email Address:_____________________________________________________________________
Emergency Contact:_____________________________ Phone #: ___________________________
Total Money Enclosed With Your Entry: $_______________ payable to SDSGA, see mail to address above
I APPLY FOR ENTRY IN THE FOLLOWING EVENTS (PLEASE CHECK and CIRCLE )
[ ] Senior Singles
50-54
[ ] Senior Mixed
50-54
[ ] Senior Doubles
50-54
55-59
Partner’s Name
60-64
65-69
70-74
75-79
80-84+
55-59
60-64
65-69
70-74
75-79
80-84+
55-59
60-64
65-69
70-74
75-79
80-84+
Partner’s Phone
Partner’s Birth Date
Partner’s Age
Doubles..:
___________________________ _______________ ______________________ ___________________
Mixed ....:
___________________________ _______________ ______________________ ___________________
LIABILITY RELEASE
Photo & Film Waiver: I hereby grant full permission to the organizers, their agents, employees, and representatives to use my name, voice, and/or picture or film in any
broadcast, telecast, advertising, promotion or other use in relation to the San Diego Senior Games Association (SDSGA) and the San Diego Senior Olympics
Liability Waver: In consideration of being allowed to participate in any way in the San Diego Senior Games Association (SDSGA) program, related events and
activities, the undersigned acknowledges, appreciates and agrees that: (1) The risk of injury from the activities involved in these programs is significant, including the
potential for permanent disability and death, and while particular rules, equipment, and personal discipline may reduce this risk, the risk of serious injury to me does
exist, and (2) I KNOWINGLY AND FREELY ASSUME ALL SUCH RISKS, both known and unknown, EVEN IF ARISING FROM THE NEGLIGENCE OF THE
RELEASEES or others, and I assume all full responsibility for my participation, and (3) I willingly agree to comply with the stated and customary terms and conditions
for participation. If I observe any unusual significant concern in my readiness for participation and/or in the program itself, I will remove myself from participation and
bring such to the attention of the nearest official immediately, and, (4) I, for myself and on behalf of my/our heirs, assigns, personal representatives and the next of kin,
HEREBY RELEASE THE SDSSF, its officers, officials, agents, volunteers and/or employees, other participants, sponsoring agencies (including USAPA), sponsors,
advertisers and if applicable, owners and lessors of the premises (including but not limited to the Castle Creek Inn) used to conduct the event (“Releasees”). WITH
RESPECT TO ANY AND ALL INJURY, DISABILITY, DEATH, or loss or damage to person or property incident to my involvement or participation in these
programs, WHETHER ARISING FROM THE NEGLIGENCE OF THE RELEASEES OR OTHERWISE, to the fullest extent permitted by law (5) I, for myself and on
behalf of my/our heirs, assigns, personal representatives and next of kin, HEREBY INDEMNIFY AND HOLD HARMLESS all the above Releasees from any and all
liabilities incident to my involvement or participation in these programs, EVEN IF ARISING FROM THEIR NEGLIGENCE, to the fullest extent permitted by law. I
have read this release of liability and assumption of risk agreement, fully understand its terms, that I have given up substantial rights by signing it, and sign it
freely and voluntarily without any inducement.
_______________________________________________________
SIGNATURE
_______________________________
DATE
2013 INDIVIDUAL ENTRY FORM
SWIM COMPETITION Sept 22, 2013
SAN DIEGO SENIOR GAMES
(AGE 50 BY 09/22/13)
Early Registration Deadline: Saturday, August 24, 2013 (postmarked)
Late Registration Deadline: Saturday, September 14, 2013 (postmarked)
COMPLETE ALL INFORMATION (FRONT & BACK) AND SIGN THE RELEASE OF LIABILITY
PERSONAL INFORMATION
LAST NAME
FIRST NAME
MI
STREET ADDRESS
–
CITY
STATE
–
–
–
TELEPHONE NUMBER WITH AREA CODE
AGE ON 9/22/13
–
BIRTHDATE (MM–DD–YYYY)
T-SHIRT SIZE:
EMAIL ADDRESS:
PERSON TO CONTACT IN CASE OF EMERGENCY
NAME:
ZIP CODE
PHONE: (
)
FEMALE
MALE
S
M
L
XL
2XL
3XL
NO T-SHIRT (check if T-shirt is NOT wanted)
RELATIONSHIP:
RELEASE OF LIABILITY
PHOTO & FILM WAIVER: I hereby grant full permission to the organizers, their agents, employees, and representatives to use my name, voice, and/or picture
or film in any broadcast, telecast, advertising, promotion or other use in relation to the San Diego Senior Games Association and the San Diego Senior Olympics.
LIABILITY WAIVER: In consideration of being allowed to participate in any way in the San Diego Senior Games Association (SDSGA) program, related events and
activities, the undersigned acknowledges, appreciates and agrees that: (1) The risk of injury from the activities involved in these programs is significant, including
the potential for permanent disability and death, and while particular rules, equipment, and personal discipline may reduce this risk, the risk of serious injury to
me does exist; and, (2) I KNOWINGLY AND FREELY ASSUME ALL SUCH RISKS, both known and unknown, EVEN IF ARISING FROM THE NEGLIGENCE OF THE
RELEASEES or others, and assume full responsibility for my participation; and, (3) I willingly agree to comply with the stated and customary terms and conditions
for participation. If I observe any unusual significant concern in my readiness for participation and/or in the program itself, I will remove myself from participation
and bring such to the attention of the nearest official immediately; and, (4) I, for myself and on behalf of my/our heirs, assigns, personal representatives and next
of kin, HEREBY RELEASE THE SDSGA, its officers, officials, agents and/or employees, other participants, sponsoring agencies, sponsors, advertisers, and if
applicable, owners and lessors of premises used to conduct the event (“Releasees”), WITH RESPECT TO ANY AND ALL INJURY, DISABILITY, DEATH, or loss
or damage to person or property incident to my involvement or participation in these programs, WHETHER ARISING FROM THE NEGLIGENCE OF THE RELEASEES
OR OTHERWISE, to the fullest extent permitted by law. (5) I, for myself and on behalf of my/our heirs, assigns, personal representatives and next of kin, HEREBY
INDEMNIFY AND HOLD HARMLESS all the above Releasees from any and all liabilities incident to my involvement or participation in these programs, EVEN IF
ARISING FROM THEIR NEGLIGENCE, to the fullest extent permitted by law.
I have read this release of liability and assumption of risk agreement, fully understand its terms, that I have given up substantial rights by signing it, and sign it
freely and voluntarily without any inducement.
PRINT NAME:
SIGNATURE:
PAYMENT INFORMATION
Registration Fee
$
Late Registration Fee
$
San Diego Sr. Games Assn. Donation
$
Total Amount Enclosed
$
(postmarked 8/25/13–09/14/13 for swimming) + $10
Deductible IRS 501(c)(3) Thank You!
Make Check Payable to & Mail to:
SDSGA
ATTN: REGISTRATION
4740 Murphy Canyon Rd, Suite #200
San Diego, CA 92123
(PLEASE DO NOT SEND CASH)
Questions: 619-226-1324 (Office)
Swimming Commissioner:
Kenton Jones, [email protected]
Complete Swimming Entry form on page 2
2013 INDIVIDUAL ENTRY FORM - SAN DIEGO SENIOR GAMES SWIMMING COMPETITION – PAGE 2
PLEASE COMPLETE PAGE 1 & 2 – SIGNATURE REQUIRED ON PAGE 1
Mail entry fee (check or money order) & both completed pages to:
SDSGA, Attn: Registration, 4740 Murphy Canyon Rd, Suite #200, San Diego, CA 92123
Meet date is 09/22/13. You may enter up to 5 total swimming events. Competition age is as of 09/22/13.
Write an entry time (the time you will swim for the event) on the line to the left of each event which you
are entering. Please do NOT enter NT or “no time.” Estimate your time if necessary. An entry time is
needed in order to seed the meet (to place swimmers in heats and lanes).
PRINT YOUR NAME:
Entry Time
Swimming Event
SW-01
SW-02
SW-03
SW-04
SW-05
SW-06
SW-07
SW-08
SW-09
SW-10
26
th
500 yd Free
50 yd Breast
200 yd Back
200 yd IM
50 yd Fly
100 yd Free
200 yd Back
50 yd Back
100 yd IM
100 yd Fly
Entry Time
Swimming Event
SW-11
SW-12
SW-13
SW-14
SW-15
SW-16
50 yd Free
100 yd Breast
100 yd Back
200 yd Fly
200 yd Free
400 yd IM
USMS # is NOT required. Masters swimmers providing a USMS number & USMS
card copy will have official times submitted for USMS National Top Ten Times.
Recognized by San Diego-Imperial Local Masters Swimming Committee for USMS
Inc. Recognition #443-R001
USMS #
(attach copy)
2013 CALIFORNIA SENIOR GAMES
ANNUAL SAN DIEGO SENIOR GAMES 2013
BILL EARLEY MEMORIAL SWIM MEET – Recognized by SI LMC for USMS Inc., #443-R001
DATE:
TIMES:
SITE:
FEES:
EVENTS:
ENTRY TIMES:
ELIGIBILITY:
RULES:
INFO:
Sunday, September 22, 2013 – AUTOMATIC TIMING WILL BE AVAILABLE
Warm-up 9:00 am, Competition starts at 10:00 am
Coggan Family Aquatic Complex, 800 Nautilus Street, La Jolla, CA 92037
The $35 registration fee and $3 for each event covers your entry into up to 5 swimming
events (and your entry into other sports).
There is a 5-event entry limit for swimming. Events will be swum in the order listed above.
Gold, silver, and bronze medals will be awarded by age group.
Submit yards entry times (the time that you think you will swim in your event). Estimate if
necessary. Do not submit “No Time.” Entry times are required in order to place you in the
proper heat and lane.
Open to swimmers age 50+ as of 09/22/13. USMS membership is NOT required. This is a USMS
recognized meet. Times will be submitted to USMS Top Ten if a USMS # is included and USMS
card copy is attached to the entry form.
Meet is pre-seeded by entry time, slow to fast, ages and sexes mixed. Awards are by 5-year
age group. US Masters Swimming rules (www.usms.org/rules) apply for all events. Violation of
stroke, turn, start. and swim suit rules will result in disqualification. Age group is determined
by your age on the meet date (USMS Rules). Remember, volunteers are running the meet;
your cooperation is appreciated.
SDSGA office, 619-226-1324, or Swimming Commissioner Kenton Jones, [email protected]
DIRECTIONS TO COGGAN FAMILY AQUATIC COMPLEX POOL, 800 Nautilus St. La Jolla, CA 92037
(25 yard x 50 meter outdoor pool located on the northwest corner of Nautilus and Fay Avenue adjacent to and east of La Jolla High School):
FROM THE NORTH: take I-5, exit west onto La Jolla Village Drive. Turn left at Torrey Pines Rd. Continue on Torrey Pines for about 3.2
miles. Turn left at Girard ("T" intersection with a light), turn immediately right onto Pearl, and turn immediately left onto Fay Avenue; drive
about 0.5 mile. The pool and parking are located on the right.
FROM THE SOUTH OR NORTH: take I-5, exit at Grand/Garnet Ave; turn west (toward ocean) at Garnet, turn right onto Soledad Mt Road.
Turn Left onto La Jolla Scenic Drive South and immediately turn right onto Nautilus St. Turn Right on Fay Ave. The pool and parking are
located on the northwest corner of Fay and Nautilus. Pool access and parking are from Fay Ave.
2013 Team Registration Form FOR OFFICE USE ONLY
Date Rec’d _________
Check No. __________
Check Amt. _________
COMPLETE ALL INFORMATION (PLEASE PRINT CLEARLY) & PLEASE SIGN WAIVER CAPTAINS MUST COMPLETE ONE TEAM REGISTRATION FORM AND ROSTER PER TEAM. List all players, non-­‐players, and captains/coaches on the roster along with other information. Name of Team: ___________________________________ CAPTAIN or PERSON REGISTERING TEAM: (Don’t forget to put yourself on the roster) FIRST NAME: ________________ LAST NAME: ______________________ MI: ______ STREET ADDRESS: _________________________________________________________ CITY: ____________________________ STATE: ________ ZIP CODE: ______________ HOME PHONE: (____) _____________________ CELL: (____) _____________________ BIRTH DATE (mm/dd/yyyy): ________________________ AGE as of 12/31/13: _______ EMAIL ADDRESS: _____________________________________ GENDER (M/F): _______ (SDSGA does not sell participant email addresses and only distributes to sponsors) CO-­‐CAPTAIN (if applicable): (Don’t forget to put this person on the roster) FIRST NAME: ________________ LAST NAME: ______________________ MI: ______ STREET ADDRESS: _________________________________________________________ CITY: ____________________________ STATE: ________ ZIP CODE: ______________ HOME PHONE: (____) _____________________ CELL: (____) _____________________ BIRTH DATE (mm/dd/yyyy): ________________________ AGE as of 12/31/13: _______ EMAIL ADDRESS: _____________________________________ GENDER (M/F): _______ (SDSGA does not sell participant email addresses and only distributes to sponsors) REGISTRATION DEADLINE IS 3 WEEKS PRIOR TO TOURNAMENT. Each player MUST register Individually. Once the Captain registers the team an email with a Link to the Registration System will be sent to each player. AGE: € 35+ € 40+ € 45+ € 50+ € 55+ € 60+ €65+ €70+ € 75+ € 80+ € 85+ 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 Team Captain Co-­‐Captain (if applicable) Basketball Maximum Volleyball Maximum Softball and Soccer Maximum Coach Non-­‐Player Extra Team Non-­‐Player Player’s Name (first and last) Email (needed for player registration) T-­‐Shirt Size C CC Player Status Player Status: C = Captain CC = Co=Captain P = Player NP = Non Player Date of Birth SPORT and minimum age: € Men’s Basketball (min. 50) € Men’s Softball (min. 50) € Men’s Volleyball (min. 50) € Women’s Basketball (min. 40) € Women’s Softball (min. 50) € Women’s Volleyball (min. 35) € Women’s Soccer (min.50) Team Name: ____________________________________ PRINT ALL PLAYERS on the ROSTER and INFORMATION LEGIBLY and FILL OUT ALL DETAILS 2013 California Senior Games Championships Team Tournament Roster Sept 22, Sunday
8am check-in
8:30 practice
Sept 21, Saturday
8am - 5pm
TBD
Archery
Badminton
Ballroom Dancing
Sept 28, Saturday
9am - 4pm
Sept 7-8, Sat-Sun
9am - 5pm
Sept 7-8, Sat-Sun
11am – 5pm
Sept 22, Sunday
8am-11am
Sept 14, Saturday
8:30am – check-in
9:00am - start
Sept 28-29
Sat 9:30 singles 12:30 doubles
Sun 9:30 mixed doubles
June 4-5
Basketball - Men
Basketball- Women
Billiards
Board Games
Bocce Ball
Bowling
Cycling
Watch Website for Details
Date / Time
Sport
Andy Gagliano
(619) 469-7769
[email protected]
Steve Fialko
(619) 778-3176
[email protected]
Jim Knott
(619) 295-8718
[email protected]
J.R. (Mitch) Mitchell
(619) 778-1007
[email protected]
Kirsten Cummings
(619) 517-0367
[email protected]
Jerry Sullivan
(619) 224-7720
[email protected]
TBD
?
?
Joe Young
(619) 647-5320
[email protected]
Rho Densmore
(760) 533-3678
[email protected]
Commissioner
2013 Schedule of Events
Pasadena Senior Games
Kearny Mesa Bowl
7585 Clairemont Mesa Blvd
San Diego, CA 92111
Elks Park Chula Vista
901 Elks Lane
Chula Vista, CA 91910
Balboa Park Horseshoe Club
6th Ave at Juniper St.
San Diego, CA 92101
College Billiards
5303 El Cajon Blvd
San Diego, CA 92115
UCSD – RIMAC Center
9730 Hopkins Drive
La Jolla, CA 92093
Harry West Gym – SD City College
1313 Park Blvd
San Diego, CA 92101
TBD
Joan Kroc Center
6845 University Ave
San Diego, CA 92115
Hope and Care Center – Bldg 27833
Marine Core Base
Camp Pendleton, CA 92055
Location
Sept 15, Sunday
7:30am – 1pm
Sept 12, Thursday
12pm – check-in
1pm – Shotgun Start
Sept 21, Saturday
8:30am – 4:30pm
Sept 15, Sunday
9am – 12:30pm
Sept 22, Sunday
11am – 3pm
Sept 29, Sunday
8:30am – 5pm
Sept 20-22, Fri-Sun
8am – 6pm
Sept 7-8, Sat-Sun
8:30am – 5pm
Sept 14-15
9/14 – 8am – 5K events
9/15 – 8am – 10K events
TBD
Fitness
Golf
Handball
Horseshoe Pitching
Lawn Games
Paddleball
Pickleball
Racquetball
Road Race & Walk
Shooting
Watch Website for Details
Oct 5-6 (possible change)
9am – 4pm
Watch Website for Details
Darts
Rick Austin
(619) 449-0121
[email protected]
Gary MacDonald
(619) 561-4235, (619) 850-9427
[email protected]
Len Sonnenberg
(858) 457-5252 ext #14
[email protected]
Audrey Phillips
(858) 756-3356
[email protected]
Len Sonnenberg
(858) 457-5252 ext #14
[email protected]
Jim Knott
(619) 295-8718
[email protected]
David Aguilera
(619) 303-1756
[email protected]
Mark Brown
(858) 204-4200
[email protected]
John Klein, PGA
(619) 980-2018
[email protected]
Rico Caveglia
(858) 274-0118
[email protected]
[email protected]
TBD
2013 Schedule of Events
TBD
Lake Miramar
10710 Scripps Lake Drive
San Diego, CA 92121
Sorrento Valley Racquetball Club
10999 Sorrento Valley Road
San Diego, CA 92121
Castle Creek Inn & Spa
29850 Circle R Drive
Escondido, CA 92026
Sorrento Valley Racquetball Club
10999 Sorrento Valley Road
San Diego, CA 92121
Balboa Park Horseshoe Club
6th Ave at Juniper Street
San Diego CA 92101
Balboa Park Horseshoe Club
6th Ave at Juniper Street
San Diego CA 92101
San Diego Tennis & Racquet Club
4848 Tecolote Road
San Diego CA 92111
Cottonwood Golf Club
3121 Willow Glen Drive
El Cajon, CA 92019
De Anza Cove Fitness Course
3000 North Mission Bay
San Diego, CA
TBD
Aug 24-25,Sat-Sun– 55+ & 65+
Sept 7-8, Sat-Sun– 50+ & 60+
Sept 21-22, Sat-Sun
8am - 5pm
Sept 7-8, Sat-Sun 50+
8am-7pm
Sept 22,Sunday
9am – warmup
10am – 2pm events
Sept 28, Saturday
8am - 5pm
Sept 9-11, Mon-Wed
12 - 5pm
Sept 22, Sunday
8:00am – 4:00pm
Sept 15, Sunday
8am-6pm
Sept 14-15, Sat-Sun
8am-6pm
TBD
Soccer – Women
Softball – Men
Softball – Women
Swimming
Table Tennis
Tennis
Track & Field
Volleyball-Men
Volleyball-Women
WheelChair Dancing
Watch Website for Details
Sept 15, Sunday
12:30pm – 4pm
Shuffleboard
Joe Torres
(619) 760-7584, (858) 573-1571
[email protected]
[email protected]
Vicky Jones
[email protected]
Vicky Jones
Gary MacDonald
(619) 561-4235, (619) 850-9427
[email protected]
Barbara Gregorio
(619) 239-8408
[email protected]
Robert Webb
(619) 321-7325
[email protected]
Kenton Jones
(858) 243-3960
[email protected]
Pat Kelly
(619) 297-9927
[email protected]
Gerry Greenhut
(619) 588-0682
[email protected]
Susan Johnston
(619) 985-5129
[email protected]
Jim Knott
(619) 295-8718
[email protected]
2013 Schedule of Events
TBD
Balboa Park Activity Center
2145 Park Blvd
San Diego, CA 92101
Balboa Park Activity Center
2145 Park Blvd
San Diego, CA 92101
San Diego Mesa College
7250 Mesa College Drive
San Diego, CA 92111
Balboa Tennis Club
2221 Morley Field Dr
San Diego, CA 92104
Balboa Park Activity Center
2145 Park Blvd
San Diego, CA 92101
Coggan Family Aquatic Complex
800 Nautilus Street
La Jolla CA 92037
Kit Carson Park
3333 Bear Valley Parkway
Escondido, CA 92025
SportsPlex USA
9951 Riverwalk Drive
Santee, CA 92071
Hourglass Park - Mira Mesa
10301 Black Mountain Rd
San Diego, CA 92126
Balboa Park Horseshoe Club
6th Ave at Juniper St.
San Diego, CA 92101
KID’S ART CONTEST
SPECIAL THANKS
Jay Wing,
Kearny High School
&
Leigh Morioka,
Dingman Elementary School,
5th Grade
OTHER SENIOR GAMES (S CHEDULES SUBJECT TO CHANGE )
May 4 - June 9, 2013
Bay Area Senior Games
Contact: Anne Warner Cribbs, Director
Email: [email protected]
Phone: 650-323-9400
website: www.bayareaseniorgames.org
May 2013
San Diego North County Senior Games
Contact: Karen Brookfield,
Games Commissioner
Email: [email protected]
Phone: 858-292-5812 (Office)
Fax: 585-292-5216
website: www.sdseniorgames.org
May 30 - June 9, 2013
Wine Country Senior Games
Contact: Amy Crabb
Email: [email protected]
Phone: 707-525-0143 X146
Council on Aging
30 Kawana Springs Rd
Santa Rosa, CA 9540
www.winecountrygames.com
May 25 - July 30, 2013
Pasadena Senior Games
Contact: Cynthia Rosedale, Coordinator
Email:
[email protected]
Phone: 626-685-6754
website: www.pasadenaseniorcenter.org
September, 2013
San Diego Senior Olympics and California
State Senior Games Championships
2013 California Senior Games State
Championships Information
Contact: Karen Brookfield,
Games Commissioner
Email: [email protected]
Phone: 858-292-5812 (Office)
Fax: 585-292-5216
website: www.sdseniorgames.org
VOLUNTEER APPLICATION
SAN DIEGO SENIOR OLYMPICS
Date: _______________________
Thank you for your interest in volunteering with the San Diego Senior Olympics. In an effort to
see how your ability, interest, and talents might be put to best use, please complete the following
information and return this form to our office. There is a great need for volunteers and your help
will be most appreciated by all. We are looking forward to seeing you this year.
Please PRINT clearly:
First Name: _______________________ Last Name: _________________________ MI: ______
Address: _______________________________________________________ APT#: ________
City: ____________________________ State: ______
Zip: _________________
Home Phone #: ______________ Cell Phone: _________________
Birthdate: _______________
Email: ________________________________________ Gender: ____ Male ____ Female
Agency Group/Club: _______________________________________ T-Shirt Size: ___________
Interest: (PLEASE CHECK ALL THAT APPLY)
_____ Participate in games
_____ Marketing
_____ Help organize an Event
_____ Computer Work/Skills
_____ Medical Volunteer
_____ Help with Luncheons
_____ Photo/Video Work
_____ Clerical/Phone Skills
_____ Help with Certain Sport ___________
_____ Sponsor an Event
_____ Donate a Prize
_____ Be A Board Member
_____ General Office Work
Other Areas of Interest / Suggestions:
_________________________________________________________________________________________________
_________________________________________________________________________________________________
_____________________________________
How did you hear about us?
_____________________________________________________________________________
Contact: Office 619-292-5812 Email: [email protected] Website: http://sdseniorgames.org
SDSGA – attn: volunteer
4740 Murphy Canyon Road #200
San Diego CA 92123
VAP100 – rev:5/28/13
THANK YOU
COMMUNITY PARTNERS & SPONSORS
THANK YOU
FOR YOUR CONTINUED SUPPORT...
THANK YOU
SAN DIEGO COUNTY AND CITY VENUES
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Park and Recreation Department, Senior Citizen Services
Congratulations to all senior athletes!
You are all winners and we are proud to
support Senior Olympics!
Everyone is welcome to join in on the fun . . .
Balboa Park Senior Lounge
Volunteer Opportunities
Senior Talent Show
Photography Contest
Storytelling Group
Poetry Party
Walking Group
Mah Jongg
Actor’s Workshop
Out of town trips
Biweekly Dances
Craft Sale
Art Contest
Piano Notes
Deaf Seniors Club
Social Services
Daily “Are You O.K.” Phone Calls
Information and Referral, including Free Legal Assistance and
Health Insurance Counseling & Advocacy Program
To receive our quarterly newsletter, The Scroll, call (619) 236-6905.
202 “C” St., MS 1-A, San Diego, CA 92101;
www.sandiego.gov/seniorservices
“We Enrich Lives Through Quality Parks and Programs”
MISSION STATEMENT
The San Diego Senior Games Association (SDSGA) is a California non-profit
corporation committed to encouraging adults, age 50 and over, to carry on
vigorous lives by developing and maintaining adequate personal physical fitness
through regular participation in recreational activities, sports, physical fitness
activities and educational programs.
___________________________________________________________________________________
NON-PROFIT
U.S. Postage
PAID
San Diego Senior Games Association
4740 Murphy Canyon Road #200
San Diego, CA 92123
Permit # 2409
San Diego, CA