You must qualify at these District games in order to compete at the State Games in Trussville, AL October 2 5, 2017.

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1 Fee: $10 (write Check to Masters Games of Alabama) Who: Men and Women Ages 50 and up from our Counties Our Counties: Blount, Cherokee, Calhoun, Cleburne, Etowah, St. Clair If you are from a different county, or have questions call Emily at Registration Deadline: Noon, May 31, 2017 Directions: Call (256) Where: Jacksonville Senior Center 501-C Alexandria Rd. SW Jacksonville, AL Events On This Day Include: (Event Times on Next Page) Basketball Free Throw Checkers Dominoes (Singles & Doubles) Frisbee Throw Horseshoes Nerfball Throw Pickleball (Doubles & Mixed Doubles) Rook Shuffleboard You can also register for the following that will only compete at the State Games. Register for them on your District Registration Form by May 31. Swimming, Bowling, Golf, &/or 5K Run/Walk. For more info, please contact... Emily McCamy at :00 am Table Tennis Directions: Call (256) Where: Anniston Army Depot Physical Fitness Center 7 Frankford Avenue (Building 206) Anniston, AL Gate List: To get into the Gate, your name must be on their list and you must show a Photo I.D. Everyone that registers for Table Tennis will be on the Gate List. If you are bringing a guest, write it on your Registration Form, or call Emily to be added to the list. 1:00 pm Billiards Directions: Call (205) Where: Pell City Senior Center 801 Comer Avenue Pell City, AL Do not fill out our District Form for these events. They have separate forms and fees. Contact Sandi Wilson at for Line Dancing Teams 3-on-3 Basketball Tournament You must qualify at these District games in order to compete at the State Games in Trussville, AL October 2 5, 2017.

2 Directions: Call (256) Where: Jacksonville Senior Center 501-C Alexandria Rd. SW Jacksonville, AL Women s Schedule: 7:30 am Registration Table Opens (ALL) 8:00 am Domino Singles (Female, 70-79) Shuffleboard (Fem., & 80+) 8:00-9:15 am Nerf & Frisbee Throw (Female) Basketball Free Throw (Female) 9:00 am Shuffleboard (Female, 70-79) Domino Singles (Fem., & 80+) 9:30 am Playoffs Nerf & Frisbee Throw (Female) Basketball Free Throw (Female) 10:00 am Horseshoes (Female) 10:00-11:00 am Softball Throw (Female) 10:30 am Checkers (Female) 10:30 am Pickleball (ALL) 11:30 am Lunch (ALL) & Announcement of Morning Winners 1:00 pm Domino Doubles (ALL) 2:00 pm Rook (ALL) Men s Schedule: 7:30 am Registration Table Opens (ALL) 8:00 am Horseshoes (Male) 8:00-9:15 am Softball Throw (Male) 9:00 am Checkers (Male) 9:30 am Domino Singles (Male) 10:00-11:00 am Basketball Free Throw (Male) Nerf & Frisbee Throw (Male) 10:30 am Pickleball (ALL) 10:30 am Shuffleboard (Male) 11:10 am Playoffs Basketball Free Throw (Male) Nerf & Frisbee Throw (Male) 11:30 am Lunch (ALL) & Announcement of Morning Winners 1:00 pm Domino Doubles (ALL) 2:00 pm Rook (ALL) Registrations Due May 31, If you have any questions, call Emily at

3 2017 Masters Games of Alabama District Entry Form Please type or print all information DISTRICT 4 Last Name First Name M.I. Address City County Zip ( ) Phone Number Male Female Date of Birth Address: How many years have you participated in Masters Games? Allergic to any medication? If yes, type(s): Yes No District shirt size (if we get them) S M L XL 2XL 3XL Age Group (please check the age group you will be in on December 31, 2016) If you are affiliated with a senior center, recreation center, or other senior group, please print the name of the center below: Please list someone with a telephone for emergency contact: Name Phone Number Fees (Please circle what you are paying): Make checks payable to Masters Games of Alabama. Some State fees are still being negotiated. If the fees you pay are incorrect, we will call you. District Registration Fee: $10.00 State Registration Fee: TBA State Bowling Fee: $10.00 State 5K Fee: $10.00 State Golf Fee per day: $40.00 State Billiards Fee: 0 For information regarding District Games, please contact: Belva Durham or Emily McCamy Diane Short Mail this to: Masters Games of AL Attn: Emily McCamy P.O. Box 2186 Anniston, AL State Information I will attend the State Games in October if I qualify: Yes No I wish to make a tax-deductible donation to Masters Games of Alabama $ Check each Meal that you plan on eating while at the State Masters Games. Monday Dinner Tuesday Lunch Dinner Wednesday Lunch Dinner Thursday Please read and sign the back side, check the events you will be entering, then return form with fees.

4 RELEASE AND AUTHORIZATION IT IS STRONGLY URGED THAT INDIVIDUALS PARTICIPATE ONLY IN THOSE EVENTS FOR WHICH THEY ARE IN GOOD PHYSICAL CONDITION TO TAKE PART. IT IS STRONGLY RECOMMENDED THAT PARTICIPANTS CONSULT THEIR DOCTORS REGARDING PRACTICE, PREPARATION, AND COMPETITION IN THE MASTERS GAMES OF ALABAMA PROGRAM. I recognize and understand that the preparation and the competition may necessitate strenuous physical activity could possibly activate any unrecognized pre-existing disorders which I may have, thereby resulting in serious or lifethreatening physical harm to me. I, THE UNDERSIGNED, BEING OF LAWFUL AGE, DO HEREBY FOR HEIRS, MY EXECUTORS, ADMINISTRATORS, AND MYSELF, RELEASE THE Masters Games of Alabama, Inc., its agents and employees, and all the individuals, agencies, corporations or other entities sponsoring The Masters Games, from any and all liability for any loss, cost, damage, or injury of any kind which I may incur as a result in whole or in part of my participation in the 2017 Masters Games. This release covers, but is not limited to, all foreseen and unforeseen bodily and personal injuries, pain and suffering, mental anguish and property damage which I may incur as a participant in The Masters Games. In addition, I hereby authorize the Masters Games of Alabama, Inc., its agents, and employees, and all individuals, agencies, corporations, or other entities sponsoring The Masters Games (hereby referred to collectively as sponsors ) to use, reproduce, and publish my name in any media advertising of the events and any and all pictures taken of me as a participant in the Masters Games. I further release the sponsors from any and all claims arising out of or connected with the use or publications of such pictures for business purposes or for any purposes as the sponsors may, in their sole discretion, determine. The sponsors have made no representations to me concerning the use of my picture. I understand that I will not receive any pay or other compensation from the sponsors for their use of my picture under their authorization. I HAVE READ THE FORGOING RELEASE AND FULLY UNDERSTAND IT. This is the day of Signature Witness Please check the events that you will participate in for District Masters Games this year. Wednesday, June 21, 2017 (in Jacksonville) Basketball Free Throw Checkers Domino Doubles (partner: ) Domino Singles Horseshoes (Women do 30 foot) (Men circle one: 30 foot or 40 foot) Nerf Throw and Frisbee Throw Pickleball Doubles (partner: ) Pickleball Mixed Doubles (partner: ) Rook (partner: ) Shuffleboard Softball Throw LUNCH Wednesday, June 28, 2017 Table Tennis (9:00 a.m. in Anniston) Billiards (1:00 p.m. in Pell City) Other Events held at State: Golf Doubles (partner: ) Golf Singles 5K Walk/Run Bowling Swimming 25 m Backstroke Swimming 50 m Backstroke Swimming 100 m Backstroke Swimming 25 m Breaststroke Swimming 50 m Breaststroke Swimming 100 m Breaststroke Swimming 25 m Freestyle Swimming 50 m Freestyle Swimming 100 m Freestyle You can only choose 6 Swimming Events. Contact Sandi Wilson at to register for Line Dancing Teams 3-on-3 Basketball Tournament

5 2017 Masters Games of Alabama State Schedule Trussville, AL Updated 04/12/17 Monday, October 2, :00 am Golf Registration & Check-In Trussville Country Club 8:30 am Golf Singles Trussville Country Club 12:00 pm 2:30 pm Registration & Check-In Trussville Civic Center (TCC) 4:00pm 6:30pm 12:30 pm Pickleball Trussville Civic Center Gym 3:00 pm Parade of Athletes TCC Exhibit Hall Opening Ceremonies 3:30 pm Dinner TCC Exhibit Hall 4:30pm - 6:15 pm BLOCK Basketball Free Throw BLOCK Softball Throw TCC gym TCC Behind Gym IMMEDIATELY FOLLOWING ***If ALL participants have thrown before the end of block time, Playoffs WILL BEGIN immediately*** Playoffs Basketball Free Throw Playoffs Softball Throw TCC Gym TCC Behind Gym 5:30 pm Checkers (ALL) TCC Fireside 1 7:00 pm 3-on-3 Basketball TCC Gym Tuesday, October 3, :30 am 11:30 am Registration & Check-In Fun Walk Trussville Civic Center (TCC) TCC indoor track 8:00 am Golf 2-Man Scramble Trussville Country Club 8:00 am Table Tennis (Male) Trussville Athletic Center 8:30 am ROOK (ALL) TCC Fireside Suites 9:00 am Table Tennis (Female) Trussville Athletic Center 9:30 am 10:30 am Snacks 9:30 am Horseshoes (Male All) Masonic Park 9:30 am Swimming Hoover Recreation Center **transportation departs TCC at 8:30am** 11:30 am Lunch Trussville Civic Center (TCC) 1:00 pm 3:00 pm Registration & Check In Fun Walk Trussville Civic Center (TCC) TCC indoor track 1:00 pm Shuffleboard (Female ALL) TCC Gym 1:30 pm Billiards (MALE ALL) Trussville Senior Center 1:30 pm 2:30 pm Concession Stand TCC 6:00 pm Awards Banquet and Entertainment TCC Exhibit Hall

6 2017 Masters Games of Alabama State Schedule Trussville, AL Updated 04/12/17 Wednesday, October 4, :30 am 11:30 am Registration & Check-In Trussville Civic Center (TCC) 7:30 am 11:30 am Fun Walk TCC indoor track 8:00 am Domino Singles (Male All) TCC - Fireside 9:00 am Horseshoes (Female ALL) Masonic Park 9:30 am 10:30 am Snacks TCC 11:30 am Lunch TCC Exhibit Hall 1:00 pm 3:00 pm Registration & Check-In Fun Walk TCC TCC indoor track 1:00 pm Domino Singles (Female All) Shuffleboard (Male ALL) TCC - Fireside TCC gym 2:30 pm Billiards (Female) Trussville Senior Center 1:30 pm 2:30 pm Snacks TCC 5:00 pm Line Dance & Campout (Dinner) TCC Exhibit Hall Thursday, October 5, :30 am 9:30 am Registration & Check-In Trussville Civic Center (TCC) 7:30 am Check In for 5K First Baptist Church Trussville 8:00 am 5k Run (ALL) Domino Doubles (All) First Baptist Church Trussville TCC - Fireside 9:30 am 10:30 am Snacks TCC 9:30 am 11:00am Nerf and Frisbee (ALL) TCC gym 10:00 am Bowling (ALL) SpareTime Trussville ***Transportation will be available to the games NOT being played at the Trussville Civic Center*** ***Please check the TRANSPORTATION schedule for events and departure times (It will be in your program when you arrive at the State Games.)*** ***Detailed directions to each site are included in your program for your convenience. (It will be in your program when you arrive at the State Games.)***