here - Windsor Essex County Senior Games

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
j4greyrescue@gmail.com
Art Barnett -519-971-0685
abarnett7@cogeco.ca
Jean Dzvirka 519-326-3700
trucking@goldenjem.com
Alice Crawford 519-326-7738
acrawford44@cogeco.ca
Dave Derbyshire
1-519-825-4404
davidd@msni.net
Al Jarvis
519-965-1730
ajtholdman@outlook.com
Al Jarvis
519-965-1730
ajtholdman@outlook.com
Al Jarvis
519-965-1730
ajtholdman@outlook.com
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
yvetteowen@hotmail.com
Dave Derbyshire
1-519-825-4404
davidd@msni.net
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
seniorcasey@sympatico.ca
Jim Blazek 519-256-3366
Ciociaro Club
3745 N Talbot
Oldcastle 519-737-6153
Rocco Lecce 519-735-1430
roccolecce900@hotmail.com
Angelo Recchia 519-966-5983
arecchia1@aol.com
Fran Rauth 519-737-6020
firauth@mnsi.net
Chuck Beedle 519-739-3281
beedle@hotmail.ca
Marjorie Nicholson
519-253-4937
nicholson227@hotmail.ca
Julie Leadbetter
519-945-6921
jleadbetter1@cogeco.ca
Malinda Hebert 519-979-3731
mahebert53@gmail.com
Sharon Andersen 519-735-2064
hansandsharon@aol.com
Fran Rauth 519-737-6020
firauth@mnsi.net
Chuck Beedle 519-739-3281
beedle@hotmail.ca
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
wandafaccer@yahoo.com
Zoe Unwin – Malden Park Day
Care 519-257-5451
Jean Dzvirka 519-326-3700
trucking@goldenjem.com
Alice Crawford 519-326-7738
acrawford44@cogeco.ca
Gill Weatherston 226-346-7000
j4greyrescue@gmail.com
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