Insert OSGA Number here _________ Windsor/Essex County Senior Games 2015 SUMMER REGISTRATION FORM PLEASE PRINT FOR CLARITY. Bring pink RECEIPT to each event and Awards Presentation. Name _____________________________________________ Address 55 + 65 + 75 + City/Town Phone 85 + Postal Email Male Female Registration is $9.00 plus event fees. Games marked with an X are Regional Games Qualifiers. For games that require a partner, please print their names in space provided. In most events, we will try to put you with a partner if you have none. Refunds are for verified Medical reasons only. Deadline for Registration is March 20, 2015. Regional Games are Thurs., Sept. 10, 2015 in London. Check Event Event Fee (Circle) Meal (Circle) Bocce - X Open Doubles $3 At venue Cribbage –Essex – X Open Doubles $2 $4.50 Doubles Men, Women, Mixed Doubles Open Pairs $2 At venue Darts – X Contract Bridge - X Duplicate Bridge $3 Open Pairs $2 $6 Euchre – Windsor – X Open Doubles $2 $7 Euchre – Leamington -X Open Doubles $2 $6 Par 3 Golf Callaway $12 9 Hole Golf / cart Callaway $25.00 18 Hole -Golf / cart – X NB - Fee includes free 9 hole pass Lawn Bowling – X Check one Pickleball–X Doubles Competitive (Wed.) ___ Rec & Open Singles (Thurs) ___ Monday____ Handicap___ Tuesday____ Handicap____ Mix Pairs___ Mix Trebles___ MD WD MX Open Singles 55+__ 65+__ 70+__ Partner or Team Members $35.00 $4.00 $7 $7.00 Per event At venue Pepper ____ – Belle River – X Open Doubles $2.00 $5 Pepper-Leamington - X Open Doubles $2.00 $6 Shuffleboard – X Open Doubles $2.00 $6 Men ___ Women____ Mixed ____ Doubles 55+ ____ 65+ ____ 75+ ____ 55+____ Singles 65+____ Men75+____ & Women $5.50 $5.00 At venue Registration Fee Singles Men & Women $5.00 At venue Event Fees $ $ 2.00 $6 Meal Fees $ Tennis – X Check age and category Each team one category 9 Ball Snooker Prediction Walk-X Men ____ Women ____ 1500m ____ 3000m ____ $ 9.00 Total: Awards Presentation and Banquet - Participant $17 Cheque #__________ Cash___________ Refunds for verified Medical reasons only. Awards Presentation and Banquet - Non-Participant $20 Make cheques payable to… Windsor-Essex County Senior Games Drop-off/mailing locations found on flyer attached or online at www.seniorgames-windsoressex.com Liability Waiver: I, the undersigned, personally and on behalf of my heirs, executors, administrators and assigns, hereby release and discharge the Ontario Senior Games Association, the Ministries of Citizenship, Culture, Tourism and Recreation, the Corporation of the City of Windsor, the Council and Administration of Essex County, all sponsors, organizers and volunteers of the Windsor/Essex County Games, their respective officers, directors, agents, representatives or successors, from any and all claims and demands that I may have, or my heirs, executors, administrators, assigns or any third party may have, for personal injuries and property damage of any nature whatsoever, arising by reason of my participation in any level of the Ontario Senior Games program. I authorize the Windsor/Essex County Senior Games Council to have such care as may be required by a physician for me, during my participation in any event of the Ontario Senior Games. I have read the above statement, understand it, and my signature confirms my acceptance. I attest and verify that I have full knowledge of the risks involved in my participation and that I am physically fit and able to participate in the said events. Note: Information below MUST be signed!! EMERGENCY INFORMATION: Do you have heart problems? Yes___ No___ Are you diabetic? Yes____ No_____ Allergies? (Specify) ______________________________________________________________________________________________________ Doctor’s Name: _____________________________ Phone: _______________ Emergency Contact: __________________ # _______________ Date: ___________________________ Participant’s Signature: _____________________________________________________ Registration Centre: (Please Print) _______________________________ Person Registering: ____________________________ Calendar of Events Summer 2015 Event Date Time Location Convenor Opening Ceremony and Euchre (Windsor) Euchre (Leamington) Tues., Apr. 14 Sign in 11:30 am Lunch 12 noon Opening 12 noon Start 12:30 pm Life After Fifty 635 McEwan, Windsor 519-254-1108 Wed., Apr. 22 Sign in 11:30 am Lunch 12 noon Start 1 pm Half Century Centre 160 Talbot St. East Leamington 519-326-2521 Duplicate Bridge Thurs., Apr. 23 Sign in 11:00 am Lunch 11:30 am Start 12:00 pm Snooker Mon., Apr. 27 Sign in 9 am Start 10:00 am Lunch Noon Shuffleboard Wed., Apr. 29 Sign in 9 am Start 9:30 am Lunch 11:30-12:30 9 Ball Fri., May 1 Sign in 11:00 am Start 12:00 pm Pepper (Belle River) Mon., May 4 Sign in 11:00 am Lunch 11:30 am Start 12:30 pm Pepper (Leamington) Thurs., May 7 Sign in 11:30 am Lunch noon Start right away Contract Bridge Thurs., May 7 Start 1 pm Half Century Centre 160 Talbot St. East Leamington 519-326-2521 Life After Fifty 635 McEwan, Windsor 519-254-1108 Life After Fifty 635 McEwan, Windsor 519-254-1108 Brews & Cues 5663 Ojibway Parkway 519-972-7200 Belle River Good Neighbour Club 272 St. Paul St. Belle River 519-728-2138 Half Century Centre 160 Talbot St. East Leamington 519-326-2521 Wheatley Friendship Club 171 Erie St. N. Wheatley Gill Weatherston 226-346-7000 [email protected] Art Barnett -519-971-0685 [email protected] Jean Dzvirka 519-326-3700 [email protected] Alice Crawford 519-326-7738 [email protected] Dave Derbyshire 1-519-825-4404 [email protected] Al Jarvis 519-965-1730 [email protected] Al Jarvis 519-965-1730 [email protected] Al Jarvis 519-965-1730 [email protected] Theresa Beaulieu 519-728-9170 Cribbage Mon., May 11 Sign in 11:30 am Lunch 12 pm Start 1 pm Darts Tues., May 12 Lunch 12 pm Sign in and Start 12:30 pm Prediction Walk Thurs., May 14 Par 3 golf Rain Fri., May 15 Wed., May 20 Sign in 10 am Start 10:30 am Lunch approx. noon Yvette Owen 1-519-326-2272 [email protected] Dave Derbyshire 1-519-825-4404 [email protected] Rain Wed., May 27 Bocce Sat., May 23 18 Hole Golf Mon., May 25 Tues., May 26 Regular Start 9 am Sign in ½ hr before tee times. You will be called with tee times. Sign in 9:30 am Sart 10:00 am Rain: June 1 & June 2 Mon-Start 9 am Tues-Start 9:30 am You will be called with tee times Tennis Wed., May 27 Finals May 29 Sign in 8:30 am Start 9 am Lawn Bowling Mon., June 1 Rain Tues., June 2 Competitive Wed., June 3 Rec/Open Sing. Thurs., June 4 Thurs., June 4 Sign In 9:30 am Start 10 am Lunch 12 noon Pickeball 9 Hole Golf Rain Thurs., June 11 Awards Presentation & Lunch Thurs., June 18 Sign in 8:00 am Start 8:30 am Regular Start 9 am Sign in ½ hr before tee times. You will be called with tee times Sign in 11:30 am Start 12 noon Essex Retirees 32 Russell St., Essex 519-776-6689 Royal Canadian Legion Br. 12 2090 Brant St. Windsor 519-256-3366 Walk – Riverfront at Assumption Park Lunch Centres for Seniors Windsor 635 McEwan 519-254-1108 Woodland Hills Golf Club 1919 County Rd/ 27, Woodslee #401 at Belle River Rd. 519-975-4653 Floyd Cascadden 519-776-8298 [email protected] Jim Blazek 519-256-3366 Ciociaro Club 3745 N Talbot Oldcastle 519-737-6153 Rocco Lecce 519-735-1430 [email protected] Angelo Recchia 519-966-5983 [email protected] Fran Rauth 519-737-6020 [email protected] Chuck Beedle 519-739-3281 [email protected] Marjorie Nicholson 519-253-4937 [email protected] Julie Leadbetter 519-945-6921 [email protected] Malinda Hebert 519-979-3731 [email protected] Sharon Andersen 519-735-2064 [email protected] Fran Rauth 519-737-6020 [email protected] Chuck Beedle 519-739-3281 [email protected] Rochester Place Golf Club 891 County Rd. 2 4 miles East of Belle River 519-728-2361 Parkside Tennis Club 6 Memorial Dr., Windsor 519-977-7746 Windsor Lawn Bowling Club 2 Memorial Dr. Jackson Park - 519-253-7860 Atlas Tube-Lakeshore 447 Renaud Line Lakeshore 519-727-0470 Rochester Place Golf Club 891 County Rd. 2 4 miles East of Belle River 519-728-2361 Croatian Centre 5259 Tecumseh Rd. E. Windsor 519-948-5322 Wanda Faccer 519-790-2244 [email protected] Zoe Unwin – Malden Park Day Care 519-257-5451 Jean Dzvirka 519-326-3700 [email protected] Alice Crawford 519-326-7738 [email protected] Gill Weatherston 226-346-7000 [email protected] Windsor Retirees Sports Activities Platinum Sponsor Lunch & Learn Oak Park LaSalle – 519-968-2000 Oak Park Terrace – 519-972-3330 Royal Marquis - 519-969-0330 Kingsville – 519-733-6558 Gold Sponsor - Openings Gold Sponsor Winter Games 4909 Riverside Drive E, Windsor 519-948-5500 Silver Sponsor Awards
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