Welcome and Congratulations!

Transcription

1 Welcome and Congratulations! Congratulations on qualifying for the 2019 National Senior Games presented by Humana. You will be part of the largest multi-sport championship in the world for men and women over the age of 50. You should be proud of that accomplishment. We encourage you to register today through the easy on-line registration system at NSGA.com. Over 95% of the 2017 Games participants utilized this service and learned how easy and accurate it was to use. Registering is your starting point for a national championship experience on the field of play as well as for an excellent multi-cultural experience. We hope you will enjoy both to the limit. We are committed to providing the best competitive conditions possible and a great time in Albuquerque, New Mexico. Mark your calendar and attend the special events and activities during The Games. The Village is the daytime hub of activity where athletes check in and all visitors can enjoy exhibits, activities and entertainment in a festive atmosphere. It is open and free to the public to attend. The 2019 Village will be located at the Albuquerque Convention Center. The Village is a great place to spend your free time by visiting with our partners, grabbing a bite to eat, socializing with long-time friends and meeting new individuals from across the country. Flame Arrival Ceremony on Saturday, June 15th All are welcome to celebrate the official start to The Games as the torch flame arrives and ignites the ceremonial cauldron on the first night of The Games. Celebration of Athletes on Wednesday, June 19th This is a combination opening and closing ceremony held in the middle of the event schedule that celebrates the achievements of the athletes. Here is where the pageantry happens, including a stirring Parade of Athletes and a warm welcome by the host city s celebrities and dignitaries. Please be sure to keep checking NSGA.com for the latest Games updates. You will find everything from hotel and travel deals to event merchandise, local attractions and competition schedules. We look forward to you joining the fun, fitness and fellowship in Albuquerque, New Mexico! Marc T. Riker CEO

2 Registration Information 1 There are two ways to register: Online - NSGA.com, Follow the How to Register Online instructions. 2 Mail-in: Complete the registration form and mail to: PO Box 5630 Clearwater, FL The NSGA cannot be responsible for lost or misdirected mail If you have questions about which events you are qualified for, please contact your state organization. For questions regarding registration, call (727) or registration@nsga.com. 1 2 Registration Questions Individual & Team Sport Registration Fees Online early registration fees end Thursday, February 28, 2019 at 11:59PM Pacific Time. Registration fees must accompany your registration form and be paid in full. Registration Fees (Per SPORT/NOT EVENT) Individual Sport One Sport Fee: Second Sport Fee (add): Third Sport Fee (add): *See Note Golf (additional fee): Team Sport Basketball Fee: Softball Fee: Volleyball Fee: Triathlon Relay Fee: *See Note Processing Fee All Registrations Fee: $9 $9 $9 $9 Note: *The Open sports of Power Walk and Triathlon Relay are the only two sports that can be added as a third sport with your other events. Open sports do not require qualification. Deadline Online Mail-In Registration Form Early Regular Early Regular $140 For the early registration discount, registrations must be completed online or postmarked by Thursday, February 28, 2019, 11:59PM Pacific Time. All Registrations must be completed online or postmarked by Tuesday, April 2, 2019, 11:59PM Pacific Time. Teams: It is the team captain s responsibility to submit the proper team fees in one payment. Rosters must be finalized by Tuesday, April 2, Roster changes must be reported to the NSGA no later than Tuesday, April 2, $575 $750 $875 0 $165 $625 $800 $925 $300 $170 $625 $800 $925 $300 $195 $675 $850 $975 $350 Mail-In Processing Fee How to Register Online 3 While we understand that some athletes need to mail in their registration forms, we are trying to encourage as many as possible to use online registration. We re doing so for several important reasons: Use of the online system will bring many new and exciting features to the users. Online registration will make communicating with you easier. We are doing as much as we can to be sensitive to environmental issues and reducing the amount of paper used by the Games. Use of online registration also helps our efforts to keep the registration fee as low as possible. Go to NSGA.com and click the link for online registration. Enter your address on file with NSGA. Forgot your password? You may request a password reset link be sent to your . Once logged in, please follow the steps to complete your registration process. The system will only allow you to register for events for which you are qualified. Partners Teams Please also see Rule E of the Rules Book in regards to rules pertaining to doubles partners. The team captain of your qualifying team is the only one who can register your team and must register first. Once your team is registered, team members must still register themselves and are subject to the one time non-refundable $9 processing fee. (see processing fee) After the captain has registered the team, the captain can view the team members by signing back into the registration screen. Captain s must submit all changes and finalize rosters no later than Tuesday, April 2, Individual/Team Processing Fee Regardless if you are an individual athlete or a team member you will need to login and register, or fill out a paper form and pay a $9 non-refundable processing fee. It is a one-time fee no matter how many sports/events or changes are made to your registration. Refunds Refunds are available with no explanation minus a $30 administration fee until Tuesday, April 2, The onetime 2019 processing fee is non-refundable. No refunds after Tuesday, April 2, 2019.

3 Mail completed registration form and payment to: PO Box 5630 Clearwater, FL Registration must be postmarked by Tuesday, April 2, 2019 June 14-25, 2019 Individual Sport Registration Form (The (NSGA) cannot be responsible for misdirected mail.) Individual Participant Waiver (must sign at end of waiver): In consideration of my participation in the 2019 National Senior Games ( The Games ) - hosted by the U.S. National Senior Sports Organization d.b.a. the ( NSGA ), I agree to assume the risks incidental to such participation (which include, but are not limited to, property damage, bodily injury and death) and on my own behalf and on behalf of my heirs, executors and administrators RELEASE AND FOREVER DISCHARGE the "released parties" of and from all liabilities, claims, actions, damages, costs or expenses of any nature arising out of or in any way connected with my participation in The Games and further agree to indemnify and hold each of the released parties harmless against any and all such liabilities, claims, actions, damages, costs or expenses including, but not limited to, all attorneys fees and disbursements. Participant understands and agrees that activities associated with The Games may be dangerous and that the NSGA cannot guarantee the safety of the Participant. Any activities Participant may take part in, whether as a component of The Games or separate from it, will be considered to have been undertaken with Participant s approval and understanding of any and all risks involved. The "released parties" are the NSGA and the Albuquerque Local Organizing Committee, related and affiliated companies, and the trustees, officers, directors, employees, faculty, students, agents, representatives, volunteers, sponsors, and venues, and the successors and assigns of each of the foregoing entities. I understand that this release, indemnity and hold harmless agreement includes any claims based on negligence, action, inaction or fault of any of the released parties and covers bodily injury (including death) and property damage related to my participation in The Games, whether suffered by me Registration Fees One Sport: Second Sport (add): Third Sport (add): Golf (add): Amount Due: $ Processing Fee: $ Donation: $ Total Amount Due: $ Early $ Regular $ Early fee ends Thurday, February 28, :59PM PT DONOR LISTING So we may properly recognize you as a donor, please write in the space above how you would like to be listed. Leave blank to remain anonymous. before, during or after such participation. This release agreement shall be construed to be as comprehensive as is allowed by law, as severable, the invalidity of any portion of which shall not affect any other portion; and shall not establish a legal or other relationship between or among the persons released by this agreement. DECLARATION OF FITNESS AND AUTHORIZATION FOR MEDICAL TREATMENT: I declare that I am physically fit and have the skill level required to participate in The Games and in my particular event(s). I further authorize the NSGA and their agents to provide me with medical treatment (including transportation to receive medical treatment) at my cost if the need arises. GRANT OF RIGHTS: I further grant the NSGA and the Albuquerque 2019 National Senior Games Local Organizing Committee, their sponsors and marketing partners, as well as the media and others to whom the NSGA and the Albuquerque 2019 National Senior Games Local Organizing Committee grant such rights, the right to photograph, videotape and/or otherwise record me and my performance and further to use my name, face, likeness, voice, appearance, and personal data for any purpose including, but not limited to, exhibitions, publicity, advertising and promotional materials without reservation, limitation or compensation. Said parties are, however, under no obligation to exercise the rights set forth in this paragraph. CANCELLATION OF GAMES: Participant understands that the NSGA reserve the right to cancel or modify The Games for any reason. CHOICE OF LAW AND CHOICE OF FORUM: This agreement shall be governed by the internal laws of the State of New Mexico without regard to conflicts of laws principles, and any legal action relating to or arising out of this Agreement shall be commenced and maintained in the state or federal courts located in Bernalillo County, New Mexico. The parties hereto consent to the exclusive jurisdiction of such courts and to Method of Payment Check or Money Order - Payable to * CARD NUMBER CREDIT CARD BILLING ADDRESS CITY STATE ZIP FOR OFFICE USE ONLY Amount Rec d: Check/M.O.#: Date Rec d: C/C Auth#: service of process outside of the State of New Mexico, and participant waives all defenses of lack of personal jurisdiction, venue and forum non conveniens. The language of all parts of this release shall in all cases be construed as a whole, according to its fair meaning, and not strictly for or against any party. This release is the only, sole, entire, and complete agreement of the parties relating in any way to the subject matter hereof. No statements, promises, or representations have been made by any party to any other, or relied upon, and no consideration has been offered or promised, other than as may be expressly provided herein. This release supersedes any earlier written or oral understandings or agreements between the parties. Participant's signature is required to complete the registration process and further indicates that the information on this form is accurate. Alteration of the form is not permitted. Participant acknowledges that she/he has read this release and that she/he understands its meaning and effect. Refunds are avaliable with no explanation minus a $30 administration fee until Tuesday, April 2, processing fee is non-refundable. Entry fees must accompany registration and be paid in full. PRINTED LEGAL NAME SIGNATURE DATE Credit Card - Please complete the information below. Discover, MasterCard and Visa Accepted. EXPIRES: PRINT NAME ON CARD SIGNATURE MONTH YEAR CVV # * Charge will appear on your credit card statement as being from the. $35 processing fee plus additional costs associated with collections of funds will be assessed for Non-Sufficient Funds Checks.

4 Participant Information (Please Print Clearly) FIRST NAME MIDDLE INITIAL LAST NAME PREFERRED NAME MAILING ADDRESS APT/SUITE MALE FEMALE CITY DAY PHONE STATE CELL PHONE (During Games Contact Phone) EMERGENCY CONTACT TELEPHONE Will you participate in the Celebration of Athletes with your state delegation? Yes No ZIP DATE OF BIRTH (MM/DD/YYYY) QUALIFYING STATE Would you like to be a volunteer during the Senior Games? Yes No Are you a USOC Olympian? Yes No Are you a Humana Member? Yes No How many National Senior Games have you attended? Are you a Veteran? Yes No Individual Sport Selection (Maximum 2 Sports) Archery Badminton (Maximum 1 event) Compound Fingers Compound Release Recurve Barebow Compound Barebow Recurve USAB Ranking Bowling Circle One: Regular or Non-Ambulatory Pickleball USAPA Number Race Walk 1,500M 5,000M Racquetball Road Race 5K Shuffleboard USA Racquetball Skill Level 10K Please refer to sport rules if you have questions (rules posted online). USAPA Player Rating Circle One: Regular or Non-Ambulatory Table Tennis Tennis USTA Member Number Track & Field Seed times & distances required for track & field events entered. Please attach paper with times and/or distances. 50M Discus Long Jump 100M USATT Number Shot Put USTA NTRP Rating Triple Jump USBC ID NUMBER Cycling Time Trials: 5K 10K Road Races: 20K 40K Golf Horseshoes (Additional ) Handicap Circle One: Regular or Non-Ambulatory Swimming (Maximum 6 events) Seed times required for events entered. Please attach paper with times. Backstroke Breaststroke Butterfly Freestyle 200Y 200Y 200Y 200Y 500Y Individual Medley 200Y 400Y If choosing bonus event(s) within the same stroke, and of lesser distance please write in your swim time(s) in the event(s) for seeding purposes. EVENT EVENT TIME TIME 200M 400M 800M 1,500M Triathlon Javelin Pole Vault High Jump Hammer Throw Individual OPEN Sport Powerwalk* USA TRIATHLON MEMBER NUMBER *Note: The Open sports of Power Walk and Triathlon Relay are the only sports that can be added as a third sport with your other events. USMS NUMBER

5 Mail completed registration form and payment to: PO Box 5630 Clearwater, FL Registration must be postmarked by Tuesday, April 2, 2019 Team Sport Participant Waiver (All participants must initial 2019 National Senior Games roster): In consideration of my participation in the 2019 National Senior Games ( The Games ) - hosted by the U.S. National Senior Sports Organization d.b.a. the ( NSGA ), I agree to assume the risks incidental to such participation (which include, but are not limited to, property damage, bodily injury and death) and on my own behalf and on behalf of my heirs, executors and administrators RELEASE AND FOREVER DISCHARGE the "released parties" of and from all liabilities, claims, actions, damages, costs or expenses of any nature arising out of or in any way connected with my participation in The Games and further agree to indemnify and hold each of the released parties harmless against any and all such liabilities, claims, actions, damages, costs or expenses including, but not limited to, all attorneys fees and disbursements. Participant understands and agrees that activities associated with The Games may be dangerous and that the NSGA cannot guarantee the safety of the Participant. Any activities Participant may take part in, whether as a component of The Games or separate from it, will be considered to have been undertaken with Participant s approval and understanding of any and all risks involved. The "released parties" are the NSGA and the Albuquerque Local Organizing Committee, related and affiliated companies, and the trustees, officers, directors, employees, faculty, students, agents, representatives, volunteers, sponsors, and venues, and the successors and assigns of each of the foregoing entities. I understand that this release, indemnity and hold harmless agreement includes any claims based on negligence, action, inaction or fault of any of the released parties and covers bodily injury (including Registration Fees Early Basketball: $ Softball: $ Volleyball: $ Triathlon Relay: * $ Process Fee(per member): $9.00 Regular $ $ $ $ $9.00 June 14-25, 2019 Team Sport Registration Form (The (NSGA) cannot be responsible for misdirected mail.) death) and property damage related to my participation in The Games, whether suffered by me before, during or after such participation. This release agreement shall be construed to be as comprehensive as is allowed by law, as severable, the invalidity of any portion of which shall not affect any other portion; and shall not establish a legal or other relationship between or among the persons released by this agreement. DECLARATION OF FITNESS AND AUTHORIZATION FOR MEDICAL TREATMENT: I declare that I am physically fit and have the skill level required to participate in The Games and in my particular event(s). I further authorize the NSGA and their agents to provide me with medical treatment (including transportation to receive medical treatment) at my cost if the need arises. GRANT OF RIGHTS: I further grant the NSGA and the Albuquerque 2019 National Senior Games Local Organizing Committee, their sponsors and marketing partners, as well as the media and others to whom the NSGA and the Albuquerque 2019 National Senior Games Local Organizing Committee grant such rights, the right to photograph, videotape and/or otherwise record me and my performance and further to use my name, face, likeness, voice, appearance, and personal data for any purpose including, but not limited to, exhibitions, publicity, advertising and promotional materials without reservation, limitation or compensation. Said parties are, however, under no obligation to exercise the rights set forth in this paragraph. CANCELLATION OF GAMES: Participant understands that the NSGA reserve the right to cancel or modify The Games for any reason. CHOICE OF LAW AND CHOICE OF FORUM: This agreement shall be governed by the internal laws of the State of New Mexico without regard to conflicts of laws principles, and any legal action relating to or arising Method of Payment Check or Money Order - Payable to * CARD NUMBER out of this Agreement shall be commenced and maintained in the state or federal courts located in Bernalillo County, New Mexico. The parties hereto consent to the exclusive jurisdiction of such courts and to service of process outside of the State of New Mexico, and participant waives all defenses of lack of personal jurisdiction, venue and forum non conveniens. The language of all parts of this release shall in all cases be construed as a whole, according to its fair meaning, and not strictly for or against any party. This release is the only, sole, entire, and complete agreement of the parties relating in any way to the subject matter hereof. No statements, promises, or representations have been made by any party to any other, or relied upon, and no consideration has been offered or promised, other than as may be expressly provided herein. This release supersedes any earlier written or oral understandings or agreements between the parties. Participant's signature is required to complete the registration process and further indicates that the information on this form is accurate. Alteration of the form is not permitted. Participant acknowledges that she/he has read this release and that she/he understands its meaning and effect. Refunds are avaliable with no explanation minus a $30 administration fee until Tuesday, April 2, processing fee is non-refundable. Entry fees must accompany registration and be paid in full. Credit Card - Please complete the information below. Discover, MasterCard and Visa Accepted. EXPIRES: MONTH YEAR CVV # Total Amount Due: $ CREDIT CARD BILLING ADDRESS PRINT NAME ON CARD Early fee ends Thursday, February 28, :59PM MT *Note: The Open sports of Power Walk and Triathlon Relay are the only two sports that can be used as a third sport with your other events. CITY STATE ZIP SIGNATURE * Charge will appear on your credit card statement as being from the. $35 processing fee plus additional costs associated with collections of funds will be assessed for Non-Sufficient Funds Checks. FOR OFFICE USE ONLY Amount Rec d: Check/M.O.#: Date Rec d: C/C Auth#:

6 Team Roster Captain s address is required. (Please print clearly - illegible rosters will be rejected) Deadline for Roster Changes Tuesday, April 2, 2019 Team Name: State Representing: Sport (circle one) Basketball Softball Volleyball Tri-Relay *OPEN* # Account # (xxxxxx) Participant's Name (First and Last) DOB M M /D D / Y Y Y Y Gender M/F Player Status see below Full Mailing Address City ST Zip Telephone with area code Address Accept Waivers A th le te 's In itia ls T eam C ap t ain 1 2 T ri- R elay M aximum B asket b all M aximum V o lleyb all M aximum So f t b all M aximum 20 So f t b all 2 1 and 2 2 N o n- Players Only Tri- Relay *OPEN * Codes: Player St at us C o d es: ( enter all that apply) A =A ssist ant C ap t ain B =B ike S=Swim R =R un C =C ap t ain P=Player K=C o ach N =N o n- Player