2015 Winter Games Registration Book

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2015 Winter Games Registration Book 2015 Board of Directors Porferia Mellado, Chair Renee Cortright, Vice

Justin Lippe (MRPA) Honorary Chair, Ted Lindsay Detroit Red Wings Alumni Send registration materials to:

org Website: www.michiganseniorolympics.org FIND US ON FACEBOOK: Michigan Senior Olympics MSO Needs You!

They range from games organizers, photographers, membership recruiters, public relations specialists,

MSO could not survive without the generosity of all the people who volunteer throughout the year.

1 2015 Winter Games Registration Book 2015 Board of Directors Porferia Mellado, Chair Renee Cortright, Vice Chair Sharon Hunt, Secretary Marye Miller, Treasurer Steve Langlois Eric Engelbarts II Ann Conklin (MRPA) Justin Lippe (MRPA) Honorary Chair, Ted Lindsay Detroit Red Wings Alumni Send registration materials to: Michigan Senior Olympics 650 Letica Drive Rochester, MI Registration Deadline: January 12, 2015 (sign up by 12/31 for a chance to win a variety of great prizes) Questions? Please feel free to contact us: (248) or (248) info@michiganseniorolympics.org Website: FIND US ON FACEBOOK: Michigan Senior Olympics MSO Needs You! Michigan Senior Olympics includes a dedicated group of volunteers. They range from games organizers, photographers, membership recruiters, public relations specialists, sports advisors, 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, Please call or volunteer@michiganseniorolympics.org if you would like to volunteer. 1

2 NATIONAL SENIOR GAMES Congratulations to the athletes from the 2014 Summer Games who have qualified to compete in the National Senior Games. The National Senior Games will take place in Bloomington - Minneapolis - St. Paul, Minnesota, July 3-16, Good luck to all the athletes!!! The 2015 Winter Games are NOT considered a qualifier for the 2015 National Senior Games. BOWLING FUNDRAISER - Classic Lanes, Rochester Hills, MI Join us at Classic Lanes in Rochester Hills, MI on Saturday, February 7th for a Bowling FUNdraiser from Noon-2pm. Cost is $15 per person (includes 2 hours of unlimited bowling, shoes, pizza, and pop). We will also have door prizes, strike ball, and a 50/50 raffle. Come support the Michigan Senior Olympics. MSO Bowlers from 2014 get a $5 discount! See flyer on page 14 for more information. SIGN UP EARLY TO WIN PRIZES (BY DECEMBER 31ST) Register by December 31st to be entered into drawing to win a variety of prizes...including a Free 2015 MSO Membership, Free Summer games registration fee, gift cards, and much more!!! MSO HALL OF FAME The Michigan Senior Olympics is accepting nominations for the MSO Hall of Fame. We will be selecting 3 athletes in Please visit the MSO website for requirements and application form at Winners will be selected at the Celebration of Athletes Dinner during the Summer Games. 2

WOMEN S ICE HOCKEY TOURNAMENT The 2nd Annual Women s Ice Hockey Tournament is tentatively scheduled for February 27 - March 1, 2015 at the Onyx Ice Arena in Rochester, MI.

!! DETROIT PISTONS FUNDRAISER (Flyer on page 12) Come join us for Michigan Senior Olympic Night at the Palace of Auburn Hills on Sunday, February 22nd to watch the Detroit Pistons vs.

Each guest will have the once-in-a-lifetime chance to take a shot on The Palace court at the end of the game!!! Feel free to bring your grandchildren and family for this great event.

3 WOMEN S ICE HOCKEY TOURNAMENT The 2nd Annual Women s Ice Hockey Tournament is tentatively scheduled for February 27 - March 1, 2015 at the Onyx Ice Arena in Rochester, MI. Please spread the word to help grow this fantastic event!!! DETROIT PISTONS FUNDRAISER (Flyer on page 12) Come join us for Michigan Senior Olympic Night at the Palace of Auburn Hills on Sunday, February 22nd to watch the Detroit Pistons vs. Washington Wizards at 3:30pm. Tickets are $10 Upper Level or $20 Lower Level. A portion of each ticket sold will come back to benefit the MSO. Each guest will have the once-in-a-lifetime chance to take a shot on The Palace court at the end of the game!!! Feel free to bring your grandchildren and family for this great event. *Free Pistons youth jersey (Greg Monroe) for first 5,000 kids 14-and-under. RED WINGS FUNDRAISER (Flyer on page 13) MSO has partnered with the Detroit Red Wings to provide discounted tickets to our supporters!!! Two price levels $40 each (reg. $65) or $25 each (reg. $55). This is a great deal! MSO Night will be Thursday, March 12th at 7:30pm vs. Columbus Blue Jackets. $5 from each ticket sold will be donated back to the Michigan Senior Olympics. *Detroit Red Wings St. Patrick s Day T-shirt Giveaway (first 5,000 fans) VOLUNTEERS NEEDED MSO is in need of volunteers to help with both the 2015 Winter and Summer Games. If you are interested please visit the MSO website at to view the volunteer schedule. All volunteers will receive a free t-shirt!!! 3

Michigan Senior Olympics 2015 Winter Games EVENTS BADMINTON Must provide own racquet. Proper court shoes required. You must register with your own doubles partner. No substitutions allowed.

You must register with your own partner. No substitutions allowed. Sanctioned tournament through USAPA. Tournament will take place at the OPC. RACQUETBALL Singles, Doubles, mixed Doubles.

All participants required to be a USAR member. Memberships will be available on-site at a discounted rate of $10. TABLE TENNIS Singles, Doubles and Mixed Doubles. Players must bring their own paddles.

4 Michigan Senior Olympics 2015 Winter Games 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 PICKLEBALL Singles, Doubles, Mixed Doubles. Must provide own paddle. Balls will be provided. You must register with your own partner. No substitutions allowed. Sanctioned tournament through USAPA. Tournament will take place at the OPC. RACQUETBALL Singles, Doubles, mixed Doubles. Must provide own racquet. Proper court shoes required. You must register with your own doubles partner. No substitutions allowed. Sanctioned through USAR. All participants required to be a USAR member. Memberships will be available on-site at a discounted rate of $10. 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. MEN S & WOMEN 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 for a complete set of rules. DANCESPORT COMPETITION: The dance levels are Novice, Pre-Championship, and Championship. Dance styles include American Smooth, American Rhythm, International Standard, International Latin, Argentine Tango, and Country Western. Entries may be Am/Am or Pro/Am. You will not be judged on attire. Judging will be based on form and style. No lifts or drops. Event guidelines will be reviewed prior to competition. You must register with a partner. Event will take place at the Royal Park Hotel. RIBBON EVENTS BOCCE BALL (RIBBON EVENT ONLY $15) 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 (RIBBON EVENT ONLY $15) 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 the Rochester Athletic Club. BILLIARDS (RIBBON EVENT ONLY $15) Men & women will compete separately with the traditional tournament. Standardized 8 Ball rules will apply. This will take place at the Older Persons Commission. 4

5 2015 Winter Games Registration Form All persons 50 years of age by December 31st, 2015 are eligible to participate Name Age Birthdate Last First Middle Initial As of 12/31/2015 Address Gender: Male Female City State Zip County Phone: Home ( ) 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. REGISTRATION: These forms must be filled in completely and the liability waiver must be signed. Registration Deadline: January 12, 2015 Sign up by Dec. 31st to be entered into a drawing to win a variety of prizes including: 2015 MSO Membership Fee, Summer Games Registration Fee, gift cards, and much more!!! 2015 MSO MEMBERSHIP FEE: (You Must Be A 2015 Member To Participate)... $25.00 = $ REGISTRATION FEE... $38.00 = $ DANCESPORT FEE $55.00 = $ RIBBON EVENT FEE: If only doing ribbon events... $15.00 = $ HOCKEY TEAM FEE:... $ = $ Medical Waiver Fee (Optional) Without the waiver you are not eligible for a refund... $ 8.00 = $ FUNDRAISERS & DISCOUNTS Discounted Detroit Pistons Tickets (See flyer on page 12)... # of Persons x $10 or $20 = $ Discounted Detroit Red Wings Tickets (See flyer on page 13)...# of Persons x $25 or $40 = $ Bowling FUNdraiser (See flyer on page 14).....# of Persons x $15.00 = $ ROYAL PARK DINNER & DANCESPORT COMPETITION: (Royal Park Hotel ) Sunday, Feb. 8, 2015, 4:00 pm MSO Member Dinner and dance... # of Persons x $40.00 = $ NON-Member Guest Dinner and dance... # of Persons x $45.00 = $ Spectator Tickets (Unassigned Seating) Dance only... # of Persons x $20.00 = $ DONATION (We are a 501(c) 3 non-profit tax-exempt organization) See flyer on page $ GRAND TOTAL (Membership, Registration, Event, & Social fees) $ Please mail forms and check to MSO, 650 Letica Dr, Rochester MI Please Note: There will be a $25.00 charge for returned checks. OFFICE USE ONLY: Date Membership Card Waiver $ Amount CK# Cash C. Card Excel Verified By 5

6 PLEASE CHECK WHAT EVENTS YOU WILL PARTICIPATE IN... MEDAL EVENTS Badminton (Feb 7-8, 9:00am) (OPC) Doubles Partner s Name (2/7) Mixed Doubles (2/7) Partner s Name Singles (2/8) Pickleball (Feb 9-12, 8:00 am) (OPC ) Mixed Doubles (2/9) Partner s Name Doubles Partner s Name (MD - 2/10, WD - 2/11) Singles (WS - 2/12, MS /11, MS /12) Racquetball (Feb 7, 9:00 am) (Warren Racquet & Fitness Club) Singles Doubles Partner s Name Mixed Doubles Partner s Name Table Tennis (Feb 8, 9:00 am) (Hart Middle School) Singles Doubles Partner s Name Mixed Doubles Partner s Name ICE HOCKEY Men s Hockey (Feb 9-11, 9:00 am) (Troy Sports Center) Team Name Women s Hockey (Feb 27-Mar 1) (Onyx)*** Team Name ***Tentative RIBBON EVENTS Billiards (Feb 12, 1:00 pm) (OPC) Singles Bocce Ball (Feb 9, 10:00 am) (Palazzo di Bocce) Partner s Name Powerlifting (Feb 9, 10:00 am) (RAC) Bench Press Deadlift DANCESPORT DanceSport (Feb 8, 5:00 pm) Please fill in entry form on Page 8. Partners Name Michigan Senior Olympics - Amateur Athletic Waiver and Release of Liability Please Read Before Signing Print Name Birth date 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. X Date Signed (Participant s Signature) 6

7 Eligibility: Men and women at least 50 years of age as of December 31, 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 12, No registrations will be accepted and no changes permitted after January 12, 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 for individual event and ribbons will be awarded for ribbon events. You must collect your medal(s) and/or ribbon (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 Saturday-Sunday February 7-8 from 8:00am - Noon and February 9-12 from 8:00am - 4:00pm. You must produce a valid picture identification to receive your credentials and you may not register for any other athlete. Medical Cancellation Waiver: You may purchase an optional Medical Cancellation Waiver for $ % 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. 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. HOST HOTEL Royal Park Hotel (4 Star Hotel) Senior Olympics preferred rate $135 Executive King Room Complimentary internet, newspapers, morning coffee, evening cookies/drinks. Make your reservation today. 24hr in-room dining, Brookshire restaurant, Commons lounge, Fitness Center and Library. 600 E University Dr., Rochester, MI

8 2015 MSO Winter Games DanceSport Competition Sunday, February 8, :00 pm 10pm (Dinner at 4pm) Royal Park Hotel, Rochester MALE NAME PRO FEMALE NAME PRO ADDRESS ADDRESS CITY STATE ZIP CITY STATE ZIP PHONE PHONE CELL DATE OF BIRTH: CELL DATE OF BIRTH: AGE GROUP: AGE GROUP: Novice - under 50 lessons and/or first year competing Pre-Championship - winner of Novice and/or lessons >1 year Championship - winner of Pre-Championship and experienced dancer American Smooth Waltz Tango Foxtrot Viennese Waltz Polka American Rhythm Cha Cha Rumba East Coast Swing Mambo Samba Merengue Hustle West Coast Swing Salsa Night Club Slow Bolero Bachata International Standard Waltz Tango Viennese Waltz Foxtrot Quickstep International Latin Cha Cha Samba Rumba Paso Doble Jive Country Western Waltz Two Step Cha Cha Polka Argentine Argentine Tango Argentine Valses Argentine Milonga Each Competitor must be a 2015 member of MSO ($25) and pay a $55 Event fee for a total of $80 per person. Your Registration grants you admittance to the Ballroom with unassigned seating. You may choose to purchase a dinner ticket which includes assigned table seating at the MSO Member price of $40 per person. Dinner is at 4pm with a cash bar beginning at 3:30pm. Your friends and supporters may buy $20 Spectator tickets, or purchase Dinner reservations at member ($40) or non-member ($45) rates depending on their status. A Few Simple Rules: Every Competitor must be 50 or more years old and registered with the Michigan Senior Olympics. Professionals may be any age but must also register with the Michigan Senior Olympics. If you are dancing with more than one partner, please complete a registration form for each partnership. Your age category is determined by the age you will be as of December 31, You must register in your proper age group. Your Age Group for a particular heat is based on the youngest person of the partnership unless it is a Pro/Am heat, in which case the Age Group is based on the age of the Amateur. You may dance all of the heats per rhythm as long as your entries are unique Pro/Am and Am/Am combinations of age group and dance level. (ex: no pro or amateur can dance with 2 partners of same age/level) Name of the Studio/Teacher you are representing: Pro/Am entries are invited. Pros do not have to be 50+. There are no Pro/Pro heats, solos or formation teams at this event. There are no syllabus requirements other than no lifts. All closed and open material is acceptable. We are offering winners of all dance heats from Summer 2015 (excluding uncontested heats) the opportunity to perform a 3-minute showcase (limit-one per dancer) during dinner (4-5pm). Any interested couples, please sign up by calling the MSO office. Space is limited. For more info call the MSO Office at (248) Deadline for entries: 1/12/15 8

9 Michigan Senior Olympics Hockey Team Roster No roster substitutions/changes after January 12, Team Name: Men Women 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 Please mail to MSO, 650 Letica Dr., Rochester, MI

10 The Michigan Senior Olympics is a 501(c) 3 non-profit organization. Michigan Senior Olympics promotes healthy lifestyles by organizing state games, sports competitions and health, fitness, and wellness programs for active individuals 50 years plus. Please become a financial fan and share this form with friends who would donate and become financial fans. Our goal is to continue to strengthen the Michigan Senior Olympics program so we will be around for many years to come. All donations are tax-deductible. Please send your check and this form to: Michigan Senior Olympics 650 Letica Dr. Rochester, MI (Checks payable to: Michigan Senior Olympics) THANK YOU FOR CONTRIBUTING TO THE MICHIGAN SENIOR OLYMPICS! $ and Over DIAMOND DONOR $ to $ PLATINUM DONOR $ to $ GOLD DONOR $50.00 to $99.00 SILVER DONOR $25.00 to $49.00 BRONZE DONOR $10.00 to $24.00 COPPER DONOR NAME ADDRESS CITY STATE ZIP CODE PHONE Can we include your name on the donor page in the MSO Results Book? Yes No (I would like to remain anonymous) 10

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MSO SUMMER GAMES August 7-16, 2015 Registration Deadline: July 10, 2015!!!! (Register by June 5th to win a variety of great prizes including a FREE summer games registration!

15 MSO SUMMER GAMES August 7-16, 2015 Registration Deadline: July 10, 2015!!!! (Register by June 5th to win a variety of great prizes including a FREE summer games registration!!!) Golf, Cycling, Pickleball, Bowling, Racquetball, Swimming, Tennis, Powerlifting, Billiards, Badminton, Bocce Ball, Dancesport, Horseshoes, Basketball, Volleyball, Archery, Track/Field, Shuffleboard, Race Walk, Table Tennis, Softball, Powerlifting, 5K & 10K Road Race Michigan Senior Olympics Phone: or info@michiganseniorolympics.org 15

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