OSGA HALTON DISTRICT #21 2007/08 WINTER and SUMMER GAMES 2008

Name: _______________________    
Address: _______________________   Please indicate Age Group:
City: _______________________   55-59 [   ]  60-64 [   ]  65-69 [   ]  70-74 [   ]  75+ [   ]
Phone: _______________________   Age eligibility: Winter games as of Dec. 31, 2006 and Summer Games as of Dec. 31, 2007
E-mail: _______________________  

2007/08 Winter Events: Fee $8* each
Alpine Skiing  [    ] 
Badminton  [    ] 
Curling  [    ] 
Duplicate Bridge  [    ] 
Ice Hockey  [    ] 
Nordic Skiing  [    ] 
Skating  [    ] 
Table Tennis  [    ] 
Ten Pin Bowling  [    ] 
Volley Ball  [    ] 
   
   
   
   
Non-sanctioned Summer Events
Nine-Ball Billiards  [    ] 
2008 Summer Events: Fee $8* each
Bid Euchre  [    ] 
Bocce  [    ] 
Carpet Bowling  [    ] 
Contract Bridge  [    ] 
Cribbage  [    ] 
Darts  [    ] 
Euchre  [    ] 
Floor Shuffleboard  [    ] 
Five Pin Bowling  [    ] 
Golf  [    ] 
Horseshoes  [    ] 
Lawn Bowling  [    ] 
Slow Pitch Baseball  [    ] 
Swimming  [    ] 
Tennis  [    ] 
Walk  [    ] 

* Some events, such as bowling, golf and curling, have additional rental and/or facility fees.

Medi Chair of Bronte Rd., Oakville has generously offered to pay the traditional $2 District #21 events fees for every participant.
OSGA fee(s) with this application = Winter $8 [    ] Summer $8 [    ]
Checks payable to: OSGA Halton District #21, 1206 DeQuincy Cr., Burlington, ON L7P 1E1 (For more information phone: (905) 332-6965 or visit www.seniorgameshalton.org)

ONTARIO SENIOR GAMES ASSOCIATION - HALTON DISTRICT #21
YEAR 2008/09 PARTICIPANT and VOLUNTEER WAIVER FORM

OSGA Event(s)______________________________________________

I, the undersigned, personally and on behalf of my heirs, executors, administrators and assigns, hereby release and forever discharge the following:

  1. The Ontario Senior Games Association
  2. The Ministry of Tourism, Culture and Recreation and the Ministry of Citizenship
  3. Halton Region and/or all Municipalities within District #21
  4. The Trillium Foundation
  5. The Sport Alliance of Ontario
  6. All sponsors, organizers and volunteers of District #21, Ontario Senior Games Association, their respective officers, directors, agents, representatives or successors, from any and all claims or demands that I 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 or volunteering at any level of the Ontario Senior Games Association Program.

I authorize the Ontario Senior Games Association and District #21 Committee to have such care, as may be required for me by medically qualified personnel during my participation in any event of the Ontario Senior Games Association’s District and/or Provincial Games.

I have read the above Statement, understood it and my signature confirms it’s acceptance. I attest and verify that I have full knowledge of the risks involved in my participation and I am physically fit and able to participate in said events.

I also agree to participate only in DISTRICT #21

ONTARIO SENIOR GAMES ASSOCIATION

Dated this ______day of _________ 20___A.D.

Participants Signature ___________________ Witness Signature _______________________