registration book - fusesport
TRANSCRIPT
REGISTRATION BOOK FEBRUARY 7-12, 2018 (Dancesport - 2/18)
Office:
(248) 608-0250
248) 608-0252
E-mail: [email protected]
Website: www.michiganseniorolympics.org
FIND US ON FACEBOOK:
Michigan Senior Olympics
VOLUNTEERS NEEDED!
Michigan Senior Olympics includes a dedicated group of volunteers.
They range from games organizers, photographers, membership
recruiters, sports coordinators, fund-raisers, office assistants and
more. MSO could not survive without the generosity of all the
people who volunteer throughout the year.
MSO is also looking for scorekeepers, timers, registration table
staff, etc., for the Winter Games to be held February 7-12, 2018.
If you are interested in volunteering please call 248-608-0250 or
email [email protected]
REGISTRATION DEADLINE: JANUARY 19, 2018
FREE EVENT - PLATFORM TENNIS
The Michigan Senior Olympics would like to invite all of our athletes and
their friends/families to come out and learn a new sport, Platform Tennis.
Platform Tennis is a racquet sport that four players can enjoy outdoors in
the cold weather because the floor is heated. This is a fun, easy to learn,
family sport! Come on out to Waterford Oaks County Park on Wednes-
day, February 7th from 1pm-2:30pm to learn more. To sign-up please
call 248-608-0252. If you are unable to make this date there are two more
free clinics being hosted by Oakland County Parks on Nov. 9th from 7-
9pm and Jan. 14th from 1:30-3:30. We hope to see you out there!
CROSS COUNTRY SKIING at Huron Meadows - 8K& 12K
The Michigan Senior Olympics has partnered with the Krazy Klassic
Cross Country Ski Race presented by Epic Racing on Sunday, January
14th at Huron Meadows Metropark in Brighton. The event features an 8K
and 12K race. Please sign-up through www.epicraces.com.
MSO Participants will receive Michigan Senior Olympic medals and
have your times recorded for MSO. GUARANTEED SNOW!!!
MSO HALL OF FAME
The Michigan Senior Olympics is accepting nominations for the
MSO Hall of Fame. We will be selecting three athletes in 2018.
Please visit the MSO website for requirements and application form at
www.michiganseniorolympics.org. Inductees will be awarded at the
Celebration of Athletes Dinner during the Summer Games.
Applications are due: June 1st!
NEW EVENT COMING TO SUMMER GAMES - POWERWALK
We are excited to announce the addition of Powerwalk to the 2018
Summer Games Schedule. This event will include both a 1500M and
5K Race! Stay tuned for more information.
Michigan Senior Olympics
2018 Winter Games
TIER I EVENTS
BADMINTON Must provide own racquet. Proper court shoes required. You must register with your own doubles partner. No substitutions allowed. Tournament will take place at the OPC, 650 Letica Dr., Rochester, MI 48307
PICKLEBALL Singles, Doubles, Mixed Doubles. Must provide own paddle. Balls will be provided. You must register with your own partner. No substitutions allowed. Tournament will take place at the OPC. Online registration is available at www.pickleballtournaments.com
TABLE TENNIS Singles, Doubles and Mixed Doubles. Players must bring their own paddles. Balls will be provided. No substitutions allowed. You must register with a partner for doubles/mixed doubles. Tournament will take place at Hart Middle School.
TEAM SPORTS
MEN’S ICE HOCKEY The following age divisions will apply: 50+; 60+; and 70+. There is an age allowance for a younger goalie The goalie’s age will not be factored into the team’s age division calculation. This tournament will be conducted in accordance with USA Hockey rules, except as modified herein. Please go to www.michiganseniorolympics.org for a complete set of rules. VOLLEYBALL (Co-Ed) 6 vs 6 3 men and 3 women on court. Event will take place at Oakland Elite Volleyball.
TIER II EVENTS BOCCE BALL Teams are comprised of two players. You must register with your team. Teams can be mixed. Soft-soled shoes are required for bocce play. Palazzo di Bocce will supply lunch at a discounted rate for participants. POWERLIFTING Bench Press and Deadlift competition is open to men and women and will compete separately. Warm-up and weigh in will be prior to your event. Event will take place at CrossFit Deviate in Rochester, MI. BILLIARDS Men & women will compete separately with the traditional tournament. Standardized 8 Ball rules will apply. This will take place at the Older Persons’ Commission. BASKETBALL SKILLS COMPETITION Includes a free throw contest and 3pt contest. Athletes will shoot 2 rounds of 20 shots each for Free Throw and 2 rounds of 15 shots each for the 3pt contest.
OTHER EVENTS CROSS COUNTRY SKIING (Krazy Klassic 8K & 12K) Please register for this event through www.epicraces.com. This event will receive MSO Medals and have times recorded in MSO results book (no t-shirts, unless purchased separately) PLATFORM TENNIS Racquet sport that four players can enjoy outdoors in the cold weather. Come learn more at this FREE CLINIC! (MSO t-shirts not included, unless purchased separately)
EVENTS
2018 MSO Board of Directors
Porferia Mellado, Chair Oakland County Circuit Court
Ann Conklin, Vice Chair Michigan Recreation & Parks Assoc.
Sharon Hunt, Secretary Retired, Waterford Parks & Rec
Eric Engelbarts II, Treasurer Meijer State Games of Michigan
Steve Langlois Oakland County Parks & Recreation
2018 Michigan Senior Olympics
Winter Games Registration Form All persons 50 years of age by December 31st, 2018 are eligible to participate
(EVENTS AND SCHEDULE ON REVERSE SIDE OF FORM)
Name _____________________________________________________________________ Age __________ Birthdate ____________
Last First Middle Initial As of 12/31/2018 Address ___________________________________________________________________ Gender: Male _________ Female _________
City ____________________________________________________ State________ Zip ____________ County ___________________
Phone: Home ( ______ ) ____________________________ Email Address ________________________________________________
Phone: Other ( _____ ) _____________________________ Shirt Size: S M L XL XXL XXXL
ARE YOU NEW TO MSO? YES or NO If yes, how did you find out about MSO: ____________________
MEMBERSHIP: MSO is a non-profit organization that organizes sports competitions, instructional clinics and
health & wellness programs for persons 50 plus. Why a membership fee? Your membership fee supports
MSO’s services and mission. Members receive the MSO Newsletter, membership pin and membership card.
The membership fee of $25.00 is an annual fee which covers the calendar year.
You Must Be A Member To Participate.
2018 MSO MEMBERSHIP FEE: ………………………………..….$25.00 = $________
TIER I REGISTRATION FEE (Includes unlimited Tier I & II events)…....…$38.00 = $________
TIER II REGISTRATION FEE: (If only doing Tier II events)…….………. $15.00 = $________
MEDICAL WAIVER FEE (Optional): ………………...…………….……..…. $ 8.00 = $________
MEN’S HOCKEY TEAM FEE (Must pay individual MSO Membership) .…$650.00 = $________
VOLLEYBALL TEAM (Membership included - Exhibition Event)……….…$175.00 = $________
ADDITIONAL T-SHIRT: ………………...………………….…. Size_____ $ 5.00 = $________
DONATION (non-profit tax-exempt organization)…………………………………………….$________
GRAND TOTAL …………………………………………………………………. $ _________
Please mail forms and check to MSO, 650 Letica Dr., Rochester MI 48307 Please Note: There will be a $25.00 charge for returned checks.
Registration Deadline: January 19, 2018 How to register: Either mail this form to MSO, 650 Letica Dr., Rochester, MI 48307 or
call (248) 608-0252 or (248) 608-0250 (Visa and MasterCard Accepted)
OFFICE USE ONLY: Date______ Waiver______ $ Amount______ CK# ______ Cash______ C. Card______ Excel______ Verified By______
TIER I EVENTS
Badminton (Feb 9th 11:00am) (OPC) 1-Day Only
Singles _____
Doubles Partner’s Name ____________________
Mixed Doubles Partner’s Name_______________
Pickleball (Feb 10-12) (OPC Senior Center)
Singles (MS - 2/10 & WS - 2/12) _____
Doubles Partner’s Name ___________________
(WD - 2/10 & MD - 2/12)
Mixed Doubles (2/11) Partner’s Name _________
Table Tennis (Feb 10, 9:00 am) (Hart Middle School)
Singles _____
Doubles Partner’s Name ____________________
Mixed Doubles Partner’s Name _______________
OTHER EVENTS
Cross Country Skiing (Jan. 14th) For more
information please call the MSO Office 248-608-0252
or visit www.epicraces.com to register.
Platform Tennis - FREE CLINIC (Feb 7th 1:00pm)
(Waterford Oaks County Park) ________
TIER II EVENTS
Billiards (Feb 9, 1:00 pm) (OPC)
Singles ____
Bocce Ball (Feb 7, 10:00 am) (Palazzo di Bocce)
Partner’s Name ___________________________
Basketball Skills (Feb 9, 9am) (OPC Senior Center)
Free Throw ________
3pt Contest ________
Powerlifting (Feb 12, 10:00 am) (CrossFit Deviate)
Bench Press ________
Deadlift ________
TEAM SPORTS
Men’s Hockey (Feb 7-9, 9:00 am)
(Troy Sports Center)
Team Name _______________________
Co-Ed Volleyball (Feb. 11, 10am) (Oakland Elite)
Team Name _______________________________
Michigan Senior Olympics - Amateur Athletic Waiver and Release of Liability
Please Read Before Signing
In consideration of being allowed to participate in any way in the Michigan Senior Olympic, Inc. athletic
sports program, related events and activities, the undersigned acknowledges, appreciates, and agrees that:
- The risk of injury from the activities involved in this program is significant, including the potential for
permanent paralysis and death, and while particular rules, equipment, and personal discipline may
reduce this risk, the risk of serious injury does exist; and,
- I knowingly and freely assume all such risks, both known and unknown, even if arising from the negligence
of the releases or others, and assume full responsibility for my participation; and,
- I, for myself and on behalf of my heirs, assigns, personal representatives and next of kin, hereby release and
hold harmless Michigan Senior Olympics, Inc., their 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 (“releases”), with respect to any and all injury, disability, death, or loss or damage to person or property,
whether arising from the negligence of the releases or otherwise. - I have read this release of liability and assumption of risk agreement, fully understand its terms, understand that I have
given up substantial rights by signing it, and sign it freely and voluntarily without any inducement.
- I also understand that any and all photographs, videos, and audio taken may be used for MSO publicity, promotion,
and publications.
Print Your Name ___________________________________________________________________________________________
Signature ____________________________________________________________________ Date ________________________
Emergency Contact______________________________________________________ Phone _____________________________
Eligibility: Men and women at least 50 years of age as of December 31, 2018. All participants must be a member of Michigan Senior Olympics. Michigan Senior Olympics is open to out of state residents. Registration: Registrations must be received in the MSO office by January 19, 2018. Awards: Awards will be presented at the event venues immediately following the competitions. Medals will be awarded to all 1st, 2nd and 3rd place finishers. You must collect your medal(s) at the conclusion of the event as they will not be mailed out. Check-in and Credentials: Your registration packet and your MSO credentials will be available at the MSO Headquarters in the OPC building at: 650 Letica Dr., Rochester, Michigan 48307. You can pick your welcome bag up Wednesday-Monday, February 7-12 from 8am-Noon. Medical Waiver: You may purchase an optional Medical Waiver for $8.00. 100% of the Registration Fee is refundable if you cancel due to a medical condition as long as you can provide documentation from your doctor. The cost of the waiver and the MSO membership are non-refundable. Refund Policy: Without a medical waiver, refunds will be made before January 19, 2018. A refund will be made with a deduction of $5.00 for a processing fee. Schedules: The competition schedules will be based on the number of participants. Updated schedules will be available at each venue and on the MSO website. Hockey schedules will be sent to team captains one week prior to the event.
SAVE THE DATE
MSO SUMMER GAMES
August 10-19, 2018
Registration Deadline: July 21, 2018!!!!
Archery, Badminton, Basketball, Billiards, Bocce Ball, Bowling,
Cycling, Dancesport (8/5), Disc Golf, Golf, Free Throw & 3Pt
Contest, Horseshoes, 5K & 10K, Pickleball, Powerlifting, Power
Walk, Race Walk, Racquetball, Shuffleboard, Softball, Swimming,
Table Tennis, Tennis, Track & Field, Triathlon, Volleyball
Michigan Senior Olympics Phone: 248-608-0252 or 248-608-0250
Email: [email protected] www.michiganseniorolympics.org
Lodging Information
Extended Stay America February 7-12, 2018
3315 University Dr., Auburn Hills, MI 48326 Call: 877-701-3383
MSO Preferred Rate: (Single Room - $75.00) (Doubles Room - $80.00)
Reserve your room by Jan. 24, 2018
Royal Park Hotel (4 Star Hotel) ONLY FOR SUNDAY, February 18, 2018
Dancesport Event 600 E University Dr., Rochester MI 48307 - 248-652-2600
MSO Preferred Rate: $169 Reserve your room by Jan. 18, 2018
Michigan Senior Olympics Men’s Hockey Team Roster
Team Fee: $650 (Individuals must also pay $25 MSO Membership Fee)
Team Name: ___________________________________________________ Age Group ________________
Team Captain: ___________________________________ Phone # ________________________________
Street: ______________________ City: ______________ State: ____ Zip: ________ County: _________
Team Manager ___________________________________ Phone # ________________________________
Street: _____________________________________ City: ________________ State: ____ Zip: _________
Maximum Players - 20
All players MUST fill out an individual registration form.
Player’s Name Birthdate Phone T-Shirt
1. _________________________________ _________________ __________________________ ___________
2._________________________________ _________________ __________________________ ___________
3._________________________________ _________________ __________________________ ___________
4._________________________________ _________________ __________________________ ___________
5._________________________________ _________________ __________________________ ___________
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Michigan Senior Olympics Co-Ed Volleyball Team Roster
Team Fee: $175/team (includes MSO membership fee)
Team Name: ____________________________________________________________________________
Team Captain: ___________________________________ Phone # ________________________________
Street: ______________________ City: ______________ State: ____ Zip: ________ County: _________
Team Manager ___________________________________ Phone # ________________________________
Street: _____________________________________ City: ________________ State: ____ Zip: _________
Maximum Players - 15
All players MUST fill out an individual registration form.
Player’s Name Birthdate Phone T-Shirt
1. ____________________________ _________________ __________________________ ___________
2.____________________________ _________________ __________________________ ___________
3.____________________________ _________________ __________________________ ___________
4.____________________________ _________________ __________________________ ___________
5.____________________________ _________________ __________________________ ___________
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