REGISTRATION NOW OPEN!

Transcription

1 Hosted by REGISTRATION NOW OPEN! Sanctioned by the FL Sports Foundation / Qualify Here for the FL Senior Games State Championships

2 Welcome Athletes! We re Celebrating 13 Years of Competition and Fun! Our dedicated team of professionals and volunteers are here to provide you with an exciting opportunity to compete in our local qualifying games. Welcome to Florida s Friendliest Hometown! During your stay take some time to discover what The Villages Lifestyle is all about! Recreation Director: JOHN B. ROHAN PURPOSE To provide and preserve the lifestyle of The Villages, Florida s Friendliest Hometown. What s Inside... Event Codes Schedule of Events Local Qualifying Information Event Location Map How To Enter Individual Entry Forms Team Entry Form The District Recreation Department VISION The Recreation Team of staff and resident volunteers will be the leader in changing the concept of recreation activities in the retirement community. MISSION To create and implement excellent recreational opportunities that promote an active and healthy lifestyle. Assistant Director of Recreation: JIM LUCAS Recreation Manager-Resident Lifestyles: PAM HENRY Recreation Staff Matt Armstrong...Marc Bugos...Dillon Burns...Jean Carroll Becky Smith...Natalie Crist...Julie Dunagan...Molly Farrar...Lynda Feustel Lori Foxall...Scott Grimes...Debbie Hurtt...Danny Jacobs...Quentin Jones Alicia Jordan...Nadia Krashefski...Kacie Linton...Becky Talley-Maholick Laura Marcille...Wendy McEldowney...Michele O Donnell Lisa Parkyn...Travis Rima...Mike Smith...Carla Wheeler...Tracy Whitten Recreation Office Staff Laura Agosto...Patti Adams...Betty Barrett...Joyce Bartlett...Meryl Boyd Jack Conser...Regina DeMarco...Larry Ditmore...Anita Douglas Delores Germakian...Nancy Gibson...Donna Grossey...Kristina Hickey Arlene Hook..Donna Oates...Wayne Ogg...Melanie Sarakinis...Nancy Schaeffer Carmen Seebald...Wendy Touchette...Kat Trulli...Joyce Veneruso For More Information call: or Visit Our Website: Good Luck Athletes and thanks to all Event Directors and Volunteers for your dedication to this year s games. Holding Company of The Villages, Inc., 2013 All Rights Reserved. The Villages is a registered trademark of Holding Company of The Villages, Inc.

3 Event Codes PLEASE USE THESE CODES WHEN FILLING OUT REGISTRATION FORMS ARCHERY ED: Dillon Burns (352) AR01MS Men s Compound Finger AR01WS Women s Compound Finger AR02MS Men s Compound Release AR02WS Women s Compound Release AR03MS Men s Recurve AR03WS Women s Recurve AR04MS Men s Barebow Compound AR04WS Women s Barebow Compound AR05MS Men s Barebow Recurve AR05WS Women s Barebow Recurve BADMINTON ED: Travis Rima (352) Travis.rima@districtgov.org BM00MS Men s Badminton Singles BM00WS Women s Badminton Singles BM00MD Men s Badminton Doubles BM00WD Women s Badminton Doubles BM00XD Mixed Badminton Doubles BASKETBALL 3-on-3 ED: Matt Armstrong (352) Matt.armstrong@districtgov.org B300MT Men s 3 on 3 Half Court B300WT Women s 3 on 3 Half Court BASKETBALL SHOOTING ED: Matt Armstrong (352) Matt.armstrong@districtgov.org BK01MS Men s Free Throw BK01WS Women s Free Throw BK02MS Men s Spot Field Goal BK02WS Women s Spot Field Goal BK03MS Men s Timed Field Goal BK03WS Women s Timed Field Goal BILLIARDS ED: Natalie Crist (352) Natalie.crist@districtgov.org BL00MS Men s Singles BL00WS Women s Singles BL00MD Men s Doubles BL00WD Women s Doubles BL00XD Mixed Doubles BOCCE ED: Alicia Jordan (352) Alicia.jordan@districtgov.org BC00XD (2) Person Teams BOWLING ED: Becky Smith (352) Becky.smith@districtgov.org BW00MS Men s Singles BW00WS Women s Singles BW00MD Men s Doubles BW00WD BW00XD Women s Doubles Mixed Doubles GOLF ED: Lori Foxall (352) Lori.foxall@districtgov.org GF00MS Men s Golf GF00WS Women s Golf HORSESHOES ED: Tracy Whitten (352) Tracy.whitten@districtgov.org HS00MS Men s Singles HS00WS Women s Singles PICKLEBALL ED: Danny Jacobs (352) Danny.jacobs@districtgov.org PB00MS Men s Singles PB00WS Women s Singles PB00MD Men s Doubles PB00WD Women s Doubles PB00XD Mixed Doubles SHUFFLEBOARD ED: Julie Dunagan (352) Julie.dunagan@districtgov.org SF00MS Men s Singles SF00WS Women s Singles SF00XD Mixed Doubles SWIMMING ED: Molly Farrar (352) Molly.farrar@districtgov.org SW01MS Men s 200yd Freestyle SW01WS Women s 200yd Freestyle SW02MS Men s 50yd Backstroke SW02WS Women s 50yd Backstroke SW03MS Men s 100yd Breaststroke SW03WS Women s 100yd Breaststroke SW04MS Men s 100yd Butterfly SW04WS Women s 100yd Butterfly SW05MS Men s 100yd Individual Medley SW05WS Women s 100yd Individual Medley SW06MS Men s 50yd Breaststroke SW06WS Women s 50yd Breaststroke SW07MS Men s 500yd Freestyle SW07WS Women s 500yd Freestyle SW08MS Men s 200yd Breaststroke SW08WS Women s 200yd Breaststroke SW09MS Men s 50yd Freestyle SW09WS Women s 50yd Freestyle SW10MS Men s 100yd Backstroke SW10WS Women s 100yd Backstroke SW11MS Men s 50yd Butterfly SW11WS Women s 50yd Butterfly SW12MS Men s 200yd Individual Medley SW12WS Women s 200yd Individual Medley SW13MS SW13WS SW14MS SW14WS Men s 100yd Freestyle Women s 100yd Freestyle Men s 200yd Backstroke Women s 200yd Backstroke TABLE TENNIS ED: Scott Grimes (352) Scott.grimes@districtgov.org TT00MS Men s Singles TT00WS Women s Singles TT00MD Men s Doubles TT00WD Women s Doubles TT00XD Mixed Doubles TENNIS ED: Wendy McEldowney (352) Wendy.mceldowney@districtgov.org TN00MS Men s Singles TN00WS Women s Singles TN00MD Men s Doubles TN00WD Women s Doubles TN00XD Mixed Doubles TRACK & FIELD ED: Lynda Feustel (352) ED: Chris Murray (352) Lynda.feustel@districtgov.org F101MS Men s Discus F101WS Women s Discus F102MS Men s High Jump F102WS Women s High Jump F103MS Men s Javelin F103WS Women s Javelin F104MS Men s Long Jump F104WS Women s Long Jump F105MS Men s Shot Put F105WS Women s Shot Put F106MS Men s Triple Jump F106WS Women s Triple Jump TR01MS Men s 100m TR01WS Women s 100m TR02MS Men s 200m TR02WS Women s 200m TR03MS Men s 400m TR03WS Women s 400m TR04MS Men s 1500m TR04WS Women s 1500m TR05MS Men s 800m TR05WS Women s 800m TR06MS Men s 1500m Race Walk TR06WS Women s 1500m Race Walk VOLLEYBALL ED: Jean Carroll (352) Jean.carroll@districtgov.org VB00MT Men s Team VB00WT Women s Team

4 Packet Pickup WEDNESDAY MARCH 27 AND THURSDAY MARCH 28 8:30AM-4:00PM SENIOR GAMES HEADQUARTERS La Hacienda Regional Recreation Center APRIL Monday 1 Tuesday 2 Wednesday 3 Thursday 4 Friday 5 Saturday 6 Sunday 7 Schedule of Events TENNIS - Singles 7:30am The Villages Tennis Courts SHUFFLEBOARD - Singles 8:30am The Villages Shuffleboard Courts TABLE TENNIS - Singles 8:30am Laurel Manor & SeaBreeze BILLIARDS - Singles 9:00am The Villages Billiard Halls BADMINTON - M/W Doubles 10:00am The Villages High School BADMINTON - Mixed Doubles 2:00pm The Villages High School TENNIS - Singles 7:30am The Villages Tennis Courts TABLE TENNIS - Doubles 8:30am Laurel Manor & SeaBreeze BILLIARDS - M/W Doubles 9:00am The Villages Billiard Halls SHUFFLEBOARD - Doubles 9:00am The Villages Shuffleboard Courts BADMINTON - Singles 10:00am The Villages High School TABLE TENNIS - Mixed Doubles Noon Laurel Manor & SeaBreeze TENNIS - M/W Doubles 7:30am The Villages Tennis Courts BASKETBALL - Shooting 8:00am The Villages High School BILLIARDS - Mixed Doubles 9:00am The Villages Billiard Halls BOCCE - Mixed Doubles 9:00am The Villages Bocce Courts TENNIS - M/W Doubles 7:30am The Villages Tennis Courts BASKETBALL - 3-on-3 Men s 8:00am The Villages High School HORSESHOES 9:00am The Villages Horseshoe Pits TENNIS - Mixed Doubles 7:30am The Villages Tennis Courts BASKETBALL - 3-on-3 Men s 8:00am The Villages High School BASKETBALL - 3-on-3 Women s 8:00am The Villages High School SWIMMING 9:00am Laurel Manor Sports Pool TENNIS - Mixed Doubles 7:30am The Villages Tennis Courts VOLLEYBALL - Mens 8:00am The Villages High & Middle Schools TRACK & FIELD - Track 8:30am The Villages High School BOWLING - Singles 9:00am Fiesta Bowl SWIMMING 9:00am Laurel Manor Sports Pool BOWLING - Mixed Doubles Noon Fiesta Bowl VOLLEYBALL - Women s 8:00am The Villages High & Middle Schools TRACK & FIELD - Field 8:30am The Villages High School ARCHERY 9:00am Paradise Archery Range BOWLING - M/W Doubles 9:00am Fiesta Bowl

5 Celebration of Athletes MONDAY APRIL 8 4-6PM Saddlebrook Softball Complex APRIL Monday 8 Thursday 18 through Saturday 20 MARCH Saturday 30 CELEBRATION OF ATHLETES 4-6pm Saddlebrook Softball Complex PICKLEBALL APRIL 18 - M/W Doubles APRIL 19 - Mixed Doubles APRIL 20 - Singles 8:00am 8:00am 8:00am The Villages Pickleball Courts 5K ROAD RACE 8:00am The Villages Polo Fields A separate Registration Form for this event will be available at: All registered athletes and guests are invited to attend. This event will feature music and light dinner. Meal tickets will be required and must be requested on your registration form. Tickets are FREE for ATHLETES ONLY. Please make sure to fill out that box on your entry form. There will also be a check box for any additional guest(s) that the athlete wishes to bring to the Celebration of Athletes. The cost for your guest is $10.00 and is to be paid in advance at the time of registration. Alcohol is not permitted. REGISTER FOR ALL EVENTS BY: OCTOBER Tuesday 1 GOLF - Men s 11:56am Tee Time Mallory Hill Country Club GOLF - Women s 11:56am Tee Time Mallory Hill Country Club The Villages Florida Senior Games are open to all athletes 50 years of age and older. Photo identification may be requested to determine eligibility. MARCH Monday11 Completed Registration Forms, including fees must be received by 5:00pm, 3/11/2013. See your Entry Form for Registration drop-off and payment information.

6 Local Qualifying Information AGE DIVISIONS: ABOUT THE EVENTS: The local qualifying events will be held at The Villages, starting April 1, The top five (5) athletes in their age divisions will be invited to compete in the Florida International Senior Games and State Championships being held in Lee County, Florida. OPEN AND EXHIBITION EVENTS: OPEN events are ones in which an athlete is not required to participate in a sanctioned Florida Local Senior Games Qualifier: Volleyball, Pickleball, Billiards, Race Walk, Road Race and Archery are considered OPEN events. EXHIBITION events are events offered at the local level, they are not qualifying events in the Florida State Senior Games SPORT REGISTRATION: You may enter as many sports, or events within a sport as you desire as long as they are not held at conflicting times, with these exceptions: Swimming up to six (6) events; Archery one (1) event; Tennis two (2) events. Check the schedule of events carefully for the date, times, and sites of the sports you wish to enter. It is the responsibility of the athlete to make sure that there are no schedule conflicts. GENERAL RULES: All sports/events shall be governed by the rules of the National Governing Body for that sport as modified herein, in the best interest of the participants. It is the responsibility of the participants to familiarize him/ herself with the rules and requirements of the Florida Senior Games. Competition must take place to determine qualifiers. If there is only one individual entered in an age group, that athlete must enter and compete in the event in order to be given the gold medal and to qualify for the Florida Senior Games State Championships. Athletes should be placed in the age division nearest their own in order to compete. Competition for the athletes in this closest age division shall be considered exhibition. If there is only one team entered in an age division, that team should be given exhibition opportunities with the closest age division. No team shall be qualified without participating in a qualifying game. The NSGA shall determine whether an athlete has met the qualifying criteria for limited sports events. FORMATS: Formats are subject to change due to participation numbers. For event formats contact each Event Director listed on the Schedule of Events pages. ATHLETE REGISTRATION PACKET: All registered participants will receive an athlete registration packet which will include a personalized schedule, commemorative t-shirt and Senior Games memorabilia. Packets can be picked up at the La Hacienda Recreation Center Headquarters. Further bracket and flight schedule information will be available on the day of the event at the event site. n Packet Pickup For Events: Wednesday - MARCH 27 and Thursday - MARCH 28} 8:30AM-4:00PM INSURANCE/MEDICAL: Insurance is the responsibility of each participant. Be sure to have proof of insurance. AWARDS: Gold, silver, and bronze medals will be awarded to the first, second, and third place finishers in each age division, per event. Runner-up ribbons will be given to the fourth and fifth place. 1st through 5th place qualifiers will advance to the Florida Senior Games State Championships in Lee County, Florida. All qualified athletes will receive State registration information by mail by October, INCLEMENT WEATHER: The Villages District Recreation Team is not responsible for changes to the event program, postponements or cancellations due to inclement weather or other circumstances beyond our control. In the event of inclement weather, every effort will be made to complete all games and events scheduled. However, the District Recreation Team reserves the right to change the schedule or format of the competition, postpone events or even cancel events due to inclement weather. NO REFUNDS will be given as a result of these circumstances. HEADQUARTERS: Senior Games headquarters will be staffed at: La Hacienda Regional Recreation Center 1200 Avenida Central - The Villages Monday - Friday: 8:30am-5:00pm Phone: (352)

7 All Event Locationson this map are indicated in RED Please review your schedule thoroughly Celebration of Athletes MONDAY APRIL 8 Wildwood

8 How To Register PLEASE READ BEFORE YOU PROCEED INDIVIDUAL ENTRIES: To enter an individual sport (non-team sport), please complete the Individual Entry Form provided in this booklet. For doubles, each partner MUST fill out an Individual Entry Form separately. 1. Complete your personal information at the top of the Individual Entry Form. Your age group is based on your age as of December 31, Both partners MUST be registered. Please have your partner listed at the time of registration, including name and date of birth. For doubles, the age group is determined by the age of the youngest partner as of December 31, Write the event code(s) and title(s) for the event(s) you wish to enter in the space provided. Each event entered counts separately when calculating fees. Please make sure to check the schedule in this program to avoid any conficts. There will be NO REFUNDS for scheduling conflicts. 3. Calculate your fees from A, B and C. (A) is the cost for the number of events you entered, (B) is any additional fees you would incur for entering specific sports, and (C) is the Celebration of Athletes. The Celebration of Athletes is free for participants, but there is an added fee of $10.00 for each guest requested. You MUST pre-register on your entry form for the Celebration of Athletes. 4. Don t forget to fill out your emergency contact information and sign the waiver. 5. Packets for all athletes will be available for pick-up at: ATHLETE HEADQUARTERS La Hacienda Regional Recreation Center on Wednesday, March 27 and Thursday, March 28. Athletes outside The Villages will be mailed an Individual Event Schedule, but will need to pick up their packet once arriving in The Villages either on March 27 or March 28 at the packet pick-up site or at the first competition site on event schedule. Check your Entry Form for the following: 4 All personal information completed. 4 Entering a PARTNERS Event? Each Partner MUST fill out a separate Entry Form indicating Event(s) entered and your partner s name and birth date. 4 Emergency contact person listed. 4 Signed Release and Waiver of Liability located on the back of Each Entry Form. TEAM ENTRIES: To enter a team sport (volleyball or basketball), the team manager or coach must complete the Team Entry Form provided in this booklet and each team member must sign the Player Waiver. Each team member does not need to fill out an Individual Entry Form or pay any individual fee, unless they wish to enter an individual sport. 1. Complete the general information section at the top of the Team Entry Form with contact information for the manager or captain. 2. Remember to mark the sport for which the team is registering on the top line of the roster. 3. Please print legibly and list the full name, mailing address, date of birth, and T-shirt size for all members on the team, including all managers. The age division is determined by the age of the youngest player as of December 31, Don t forget to request your Celebration of Athletes ticket. All registered athletes attend free. Guests may attend for an additional $10.00 each and must be requested on the entry and included with team fees. 5. Please complete the Player Waiver. All team members must sign and date the waiver. HOW TO PAY FOR YOUR EVENTS IN PERSON OR MAIL: * La Hacienda Recreation Center 1200 Avenida Central The Villages, Florida *Please include payment FAX: (352) ** ONLY COMPLETE FORMS WILL BE PROCESSED. THERE WILL BE NO REFUNDS. **PLEASE INCLUDE CREDIT card information and/or your check made payable to: VCDD

9 Individual Entry Form Registration includes: T-shirt, Celebration of Athletes Ticket and Registration Packet Athletes receive one (1) complimentary ticket to the Celebration of Athletes. Guests may attend. Each additional ticket is $ Please Print in Blue or Black Ink

10 INDIVIDUAL AGREEMENT RELEASE AND WAIVER OF LIABILITY In consideration of being permitted to participate in recreational activities or events (the Activity or Activities) sponsored, promoted, held, or conducted by the Activity Sponsor (as defined herein), I, for myself and for my executors, administrators, personal representatives, assigns, heirs, and next of kin, DO HEREBY: 1. RELEASE, WAIVE, FOREVER DISCHARGE, HOLD HARMLESS, AND COVENANT NOT TO SUE The Villages of Lake-Sumter, Inc., The Villages Holding Company, The Villages Operating Company, The Village Center Community Development District, Sumter Landing Community Development District, The Villages Recreation Department, The Villages Golf Department, Golf Management Solutions, LLC, State of Florida Sports Foundation, any sponsor, advertiser, and promoter of any of the Activities, and any owner or lessee of the premises where the Activities are held or conducted, and each of them, their officers, directors, members, executives, agents, employees, affiliates, representatives, successors and assigns (collectively and individually referred to as the Activity Sponsor) of all liability to me or my executors, administrators, personal representatives, assigns, heirs, and next of kin, for any and all loss or damage, and all claims or demands therefore, on account of injury to my person or property or resulting in my death, arising out of or in any way connected with my participation or involvement in or presence at the Activities, suffered before, during or after the Activities, whether caused by the negligence, action or inaction of the Activity Sponsor or otherwise. This release applies for all future entrances to the premises or this release applies each and every time a person is on the premises. 2. INDEMNIFY AND HOLD HARMLESS the Activity Sponsor from and against any loss, liability, damage or cost that I or any of my guests may incur due to participation or involvement in or presence at the Activities, whether caused by negligence, action or inaction of the Activity Sponsor or otherwise. 3. ASSUME FULL RESPONSIBILITY FOR AND RISK OF BODILY INJURY, DEATH OR PROPERTY DAMAGE arising out of or in any way connected with my participation or involvement in or presence at the Activities suffered before, during or after the Activities, whether caused by the negligence, action or inaction of the Activity Sponsor or otherwise. I understand that my participation or involvement in or presence at the Activities carry the risk of injury or death or property damage and I accept and assume that risk fully, freely and voluntarily. 4. AGREE that the foregoing release, waiver and indemnity agreement is intended to be as broad and inclusive as is permitted by Florida law, and that if any portion is held invalid for any reason, the balance should notwithstanding, continue in full legal force and effect. 5. AGREE that this release agreement is intended to apply to my or my guest s participation or involvement in or presence at any Activity. The Activity Sponsor has made no representations or inducements apart from the foregoing. 6. IRREVOCABLY GRANT to the Activity Sponsor the absolute right and permission to use any pictures, photographs, movies, images, videos, recordings, or motion pictures taken of me or my property by the Activity Sponsor (collectively the Images) and to further use any statements, quotes, recordings or testimonials made by me (collectively the Testimonials); To copyright the Images or Testimonials in the Activity Sponsors own name or in any name Activity Sponsor may choose; To use, re-use, publish, display or reproduce the Images or Testimonials in any medium and for any commercial purpose whatsoever, including but not limited to, promotion, advertising, display, sale or trade, without restriction or limitation; To use my name in connection with the use of any such Images or Testimonials at the Activity Sponsors sole discretion; all without compensation, royalty or remuneration of any kind. I waive any rights to inspect or approve the Images or the Testimonials, their use, or any printed or audio matter that may be used in connection therewith, without restriction or limitation, whatsoever. I hereby release and forever discharge the Activity Sponsor from any and all claims and demands arising out of or in connection with the use of the Images or the Testimonials, including, but not limited to, any claims for slander, libel or invasion of privacy or right of publicity, as well as any claims due to any technical failures or distortions in the Images or Testimonials that may occur in taking the original Images or Testimonials, or in the subsequent processing thereof. I waive any right, title or interest in or to the Images or Testimonials and acknowledge that the Activity Sponsor is the sole and absolute owner thereof and of any printed material, electronic media, negatives, film, video tape or audio tape containing such Images or Testimonials. 7. AGREE to abide at all times to the following Code of Conduct at any Activity: The use of obscenity, profanity or vulgarity in any conversations involving participants will not be tolerated. It is everyone s responsibility to maintain a safe, pleasant and comfortable playing atmosphere. Every individual who participates in this program has the right to be treated with respect. No one should be disparaged or criticized in front of teammates and spectators. Bring your complaints or concerns to your recreation department representative. They will investigate and address any concerns. I further agree that my participation or involvement in or presence at any Activity is a privilege rather than a right, and that the Activity Sponsor reserves the right within its sole discretion to revoke my or my guest s Activity Privileges, for violations of the Code of Conduct. I HAVE READ THE FOREGOING AGREEMENT AND THE CODE OF CONDUCT IN ITS ENTIRETY AND I HEREBY FREELY AND VOLUNTARILY SIGN THIS AGREEMENT, INTENDING TO BE BOUND THEREBY. PARTICIPANT SIGNATURE: DATE: PARTICIPANT NAME (PLEASE PRINT): STREET ADDRESS / CITY / STATE: / / PHONE: VILLAGES ID # (If Applicable):

11 Individual Entry Form Registration includes: T-shirt, Celebration of Athletes Ticket and Registration Packet Athletes receive one (1) complimentary ticket to the Celebration of Athletes. Guests may attend. Each additional ticket is $ Please Print in Blue or Black Ink

12 INDIVIDUAL AGREEMENT RELEASE AND WAIVER OF LIABILITY In consideration of being permitted to participate in recreational activities or events (the Activity or Activities) sponsored, promoted, held, or conducted by the Activity Sponsor (as defined herein), I, for myself and for my executors, administrators, personal representatives, assigns, heirs, and next of kin, DO HEREBY: 1. RELEASE, WAIVE, FOREVER DISCHARGE, HOLD HARMLESS, AND COVENANT NOT TO SUE The Villages of Lake-Sumter, Inc., The Villages Holding Company, The Villages Operating Company, The Village Center Community Development District, Sumter Landing Community Development District, The Villages Recreation Department, The Villages Golf Department, Golf Management Solutions, LLC, State of Florida Sports Foundation, any sponsor, advertiser, and promoter of any of the Activities, and any owner or lessee of the premises where the Activities are held or conducted, and each of them, their officers, directors, members, executives, agents, employees, affiliates, representatives, successors and assigns (collectively and individually referred to as the Activity Sponsor) of all liability to me or my executors, administrators, personal representatives, assigns, heirs, and next of kin, for any and all loss or damage, and all claims or demands therefore, on account of injury to my person or property or resulting in my death, arising out of or in any way connected with my participation or involvement in or presence at the Activities, suffered before, during or after the Activities, whether caused by the negligence, action or inaction of the Activity Sponsor or otherwise. This release applies for all future entrances to the premises or this release applies each and every time a person is on the premises. 2. INDEMNIFY AND HOLD HARMLESS the Activity Sponsor from and against any loss, liability, damage or cost that I or any of my guests may incur due to participation or involvement in or presence at the Activities, whether caused by negligence, action or inaction of the Activity Sponsor or otherwise. 3. ASSUME FULL RESPONSIBILITY FOR AND RISK OF BODILY INJURY, DEATH OR PROPERTY DAMAGE arising out of or in any way connected with my participation or involvement in or presence at the Activities suffered before, during or after the Activities, whether caused by the negligence, action or inaction of the Activity Sponsor or otherwise. I understand that my participation or involvement in or presence at the Activities carry the risk of injury or death or property damage and I accept and assume that risk fully, freely and voluntarily. 4. AGREE that the foregoing release, waiver and indemnity agreement is intended to be as broad and inclusive as is permitted by Florida law, and that if any portion is held invalid for any reason, the balance should notwithstanding, continue in full legal force and effect. 5. AGREE that this release agreement is intended to apply to my or my guest s participation or involvement in or presence at any Activity. The Activity Sponsor has made no representations or inducements apart from the foregoing. 6. IRREVOCABLY GRANT to the Activity Sponsor the absolute right and permission to use any pictures, photographs, movies, images, videos, recordings, or motion pictures taken of me or my property by the Activity Sponsor (collectively the Images) and to further use any statements, quotes, recordings or testimonials made by me (collectively the Testimonials); To copyright the Images or Testimonials in the Activity Sponsors own name or in any name Activity Sponsor may choose; To use, re-use, publish, display or reproduce the Images or Testimonials in any medium and for any commercial purpose whatsoever, including but not limited to, promotion, advertising, display, sale or trade, without restriction or limitation; To use my name in connection with the use of any such Images or Testimonials at the Activity Sponsors sole discretion; all without compensation, royalty or remuneration of any kind. I waive any rights to inspect or approve the Images or the Testimonials, their use, or any printed or audio matter that may be used in connection therewith, without restriction or limitation, whatsoever. I hereby release and forever discharge the Activity Sponsor from any and all claims and demands arising out of or in connection with the use of the Images or the Testimonials, including, but not limited to, any claims for slander, libel or invasion of privacy or right of publicity, as well as any claims due to any technical failures or distortions in the Images or Testimonials that may occur in taking the original Images or Testimonials, or in the subsequent processing thereof. I waive any right, title or interest in or to the Images or Testimonials and acknowledge that the Activity Sponsor is the sole and absolute owner thereof and of any printed material, electronic media, negatives, film, video tape or audio tape containing such Images or Testimonials. 7. AGREE to abide at all times to the following Code of Conduct at any Activity: The use of obscenity, profanity or vulgarity in any conversations involving participants will not be tolerated. It is everyone s responsibility to maintain a safe, pleasant and comfortable playing atmosphere. Every individual who participates in this program has the right to be treated with respect. No one should be disparaged or criticized in front of teammates and spectators. Bring your complaints or concerns to your recreation department representative. They will investigate and address any concerns. I further agree that my participation or involvement in or presence at any Activity is a privilege rather than a right, and that the Activity Sponsor reserves the right within its sole discretion to revoke my or my guest s Activity Privileges, for violations of the Code of Conduct. I HAVE READ THE FOREGOING AGREEMENT AND THE CODE OF CONDUCT IN ITS ENTIRETY AND I HEREBY FREELY AND VOLUNTARILY SIGN THIS AGREEMENT, INTENDING TO BE BOUND THEREBY. PARTICIPANT SIGNATURE: DATE: PARTICIPANT NAME (PLEASE PRINT): STREET ADDRESS / CITY / STATE: / / PHONE: VILLAGES ID # (If Applicable):

13 TEAM REGISTRATION FEES (Please Circle Category) Basketball Men s B300MT $60 Basketball Women s B300WT $60 Volleyball Men s VB00MT $70 Volleyball Women s VB00WT $70 + Celebration Guest(s) X $10 each = TOTAL FEES $ Team Entry Form Please Print in Blue or Black Ink Registration includes: T-shirt, Celebration of Athletes Ticket and Registration Packet Athletes receive one (1) complimentary ticket to the Celebration of Athletes. Guests may attend. Each additional ticket is $ AGE Division: n 50+ n 55+ n 60+ n 65+ n 70+ n 75+ Age of Youngest Player on Team (As of 12/31/13) MEN S Division: n WOMEN S Division: n Manager s T-Shirt Size: (Circle One) S M L XL XXL Manager attending Celebration of Athletes: n YES n NO Team Name Coach s/manager s Name (First, Last) Street Address City State Zip ( ) Phone Number TEAM ROSTER Basketball 3-on-3 (Maximum 10 Players) Volleyball (Maximum 15 Players) Player Name (Print) Address/City/State/Zip DOB Player Signature/Date Celebration of Athletes Attending? # of Yes/No Guests >>>>>>>>>>>>>>>>>>>>>>>> (Look on back for continued Volleyball Team Roster form) <<<<<<<<<<<<<<<<<<<<<<<< PAYMENT TYPE: Cash MasterCard Visa Check > Make checks payable to: VCDD (There will be a $30.00 charge for all returned checks.) Mail entry form to: VCDD 1200 Avenida Central, The Villages Florida Credit Card Payment: Please write card number and expiration date> Expiration Date: / / (All credit card numbers are disposed of after registration is complete) ON THE BACK: Team Roster Form (continued), Agreement, Release and Waiver of Liability, and Emergency Contact information. T-Shirt Size S - XXL

14 TEAM ROSTER Basketball 3-on-3 (Maximum 10 Players) Volleyball (Maximum 15 Players) Player Name (Print) Address/City/State/Zip DOB Player Signature/Date Celebration of Athletes Attending? # of Yes/No Guests T-Shirt Size S - XXL TEAM AGREEMENT, RELEASE AND WAIVER OF LIABILITY In consideration of being permitted to participate in recreational activities or events (the Activity or Activities) sponsored, promoted, held, or conducted by the Activity Sponsor (as defined herein), I, for myself and for my executors, administrators, personal representatives, assigns, heirs, and next of kin, DO HEREBY: 1. RELEASE, WAIVE, FOREVER DISCHARGE, HOLD HARMLESS, AND COVENANT NOT TO SUE The Villages of Lake-Sumter, Inc., The Villages Holding Company, The Villages Operating Company, The Village Center Community Development District, Sumter Landing Community Development District, The Villages Recreation Department, The Villages Golf Department, Golf Management Solutions, LLC, State of Florida Sports Foundation, any sponsor, advertiser, and promoter of any of the Activities, and any owner or lessee of the premises where the Activities are held or conducted, and each of them, their officers, directors, members, executives, agents, employees, affiliates, representatives, successors and assigns (collectively and individually referred to as the Activity Sponsor) of all liability to me or my executors, administrators, personal representatives, assigns, heirs, and next of kin, for any and all loss or damage, and all claims or demands therefore, on account of injury to my person or property or resulting in my death, arising out of or in any way connected with my participation or involvement in or presence at the Activities, suffered before, during or after the Activities, whether caused by the negligence, action or inaction of the Activity Sponsor or otherwise. This release applies for all future entrances to the premises or this release applies each and every time a person is on the premises. 2. INDEMNIFY AND HOLD HARMLESS the Activity Sponsor from and against any loss, liability, damage or cost that I or any of my guests may incur due to participation or involvement in or presence at the Activities, whether caused by negligence, action or inaction of the Activity Sponsor or otherwise. 3. ASSUME FULL RESPONSIBILITY FOR AND RISK OF BODILY INJURY, DEATH OR PROPERTY DAMAGE arising out of or in any way connected with my participation or involvement in or presence at the Activities suffered before, during or after the Activities, whether caused by the negligence, action or inaction of the Activity Sponsor or otherwise. I understand that my participation or involvement in or presence at the Activities carry the risk of injury or death or property damage and I accept and assume that risk fully, freely and voluntarily. 4. AGREE that the foregoing release, waiver and indemnity agreement is intended to be as broad and inclusive as is permitted by Florida law, and that if any portion is held invalid for any reason, the balance should notwithstanding, continue in full legal force and effect. 5. AGREE that this release agreement is intended to apply to my or my guest s participation or involvement in or presence at any Activity. The Activity Sponsor has made no representations or inducements apart from the foregoing. 6. IRREVOCABLY GRANT to the Activity Sponsor the absolute right and permission to use any pictures, photographs, movies, images, videos, recordings, or motion pictures taken of me or my property by the Activity Sponsor (collectively the Images) and to further use any statements, quotes, recordings or testimonials made by me (collectively the Testimonials); To copyright the Images or Testimonials in the Activity Sponsors own name or in any name Activity Sponsor may choose; To use, re-use, publish, display or reproduce the Images or Testimonials in any medium and for any commercial purpose whatsoever, including but not limited to, promotion, advertising, display, sale or trade, without restriction or limitation; To use my name in connection with the use of any such Images or Testimonials at the Activity Sponsors sole discretion; all without compensation, royalty or remuneration of any kind. I waive any rights to inspect or approve the Images or the Testimonials, their use, or any printed or audio matter that may be used in connection therewith, without restriction or limitation, whatsoever. I hereby release and forever discharge the Activity Sponsor from any and all claims and demands arising out of or in connection with the use of the Images or the Testimonials, including, but not limited to, any claims for slander, libel or invasion of privacy or right of publicity, as well as any claims due to any technical failures or distortions in the Images or Testimonials that may occur in taking the original Images or Testimonials, or in the subsequent processing thereof. I waive any right, title or interest in or to the Images or Testimonials and acknowledge that the Activity Sponsor is the sole and absolute owner thereof and of any printed material, electronic media, negatives, film, video tape or audio tape containing such Images or Testimonials. 7. AGREE to abide at all times to the following Code of Conduct at any Activity: The use of obscenity, profanity or vulgarity in any conversations involving participants will not be tolerated. It is everyone s responsibility to maintain a safe, pleasant and comfortable playing atmosphere. Every individual who participates in this program has the right to be treated with respect. No one should be disparaged or criticized in front of teammates and spectators. Bring your complaints or concerns to your recreation department representative. They will investigate and address any concerns. I further agree that my participation or involvement in or presence at any Activity is a privilege rather than a right, and that the Activity Sponsor reserves the right within its sole discretion to revoke my or my guest s Activity Privileges, for violations of the Code of Conduct. I HAVE READ THE FOREGOING AGREEMENT AND THE CODE OF CONDUCT IN ITS ENTIRETY AND I HEREBY FREELY AND VOLUNTARILY SIGN THIS AGREEMENT, INTENDING TO BE BOUND THEREBY. EMERGENCY CONTACT NAME: PHONE #:

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16 Call: or Log On To: THE COMPLETE OFFERING TERMS ARE IN A PLAN AVAILABLE FROM SPONSOR, FILE NO. H The Villages is a community for persons age 55 or better. Prices and availability subject to change without notice The Villages Florida, Inc. All Rights Reserved.