26th Annual
Macon County Senior Games
Official Registration Form
April 25th – May 17th 2016
Hosted by Macon County Recreation Department
This program is sanctioned by the N.C. Senior Games, Inc. NCSG is sponsored statewide by N.C. Division of Aging.
Please take time to review the schedule of events.
You may enter all the events you wish on the entry form.
WE WILL NOT BE ABLE TO ADMIT LATE ENTRIES OR MAKE CHANGES AFTER YOUR REGISTRATION IS SUBMITTED.
Please take an entry form for a friend and introduce them to Senior Games.
Thanks for your cooperation.
Macon County Senior Games
“Life is over when you quit, join Senior Games and you’ll stay fit”
“Fun, Fellowship and Fitness”
To be eligible to participate, complete the registration form and return to the Macon County Community Facilities Building by the
Deadline of April 20th 2016
Registration $20.00
Reminder that all events are Non-Smoking!
Macon County Senior Games
1288 Georgia Rd.
Franklin, NC 28734
828-349-2090
maconcountyseniorgames.org
Official EventsArchery
Badminton (Singles, Doubles, Mixed)
Basketball Shooting Basketball Tournament
Billiards Bocce Bowling (Singles, Doubles, Mixed) Cornhole (Singles) Croquet Cycling 1mile 5K 10K
Field events
Discus
Shot put
Long Jumps (Standing and Running)
Football Throw
Golf
Horseshoes /
Pickleball (Singles, Doubles, Mixed)
Raquetball
Shuffleboard
Softball Throw
Spincasting
Swimming
50, 100, 200 yd. Backstroke
50, 100, 200 yd. Breaststroke
50, 100, 200 yd. Butterfly 50,
100, 200 yd. Individual Medley
100, 200, 500 yd. Freestyle
Table Tennis (Singles, Doubles, Mixed)
Tennis (Singles, Doubles, Mixed)
Track Events
100m, 200m, 400m Dash
800m, 1500m, 5K Runs
1500m, 5K Race Walks
Silver Striders Fun Walk
Age categories
Your age group is determined by your age as of December 31, 2016 Men and women compete
in separate categories in the following age groups: 50-54, 55-59, 60-64, 65-69, 70-74, 75-79, 80-84,
85+, except in tournament doubles where the age of the youngest player will determine the age group.
Eligibility
You must be a resident of Macon County for 3 months. You must be present at each event
that you are registered for. You can not submit a time or score for these events.
Fees
There is a registration fee of $20.00. If you bowl, or play billiards, racquetball or golf there is
an extra fee to be paid on site. Registration fee includes: T-Shirt and Banquet with lots of fun
and fellowship.
Registration
You must register by April 20, 2016. Complete the registration form in this pamphlet. Be sure
to fill in all information and sign the liability waiver. Mail Registration form to: Macon County Recreation Department, 1288 Georgia Rd., Franklin, NC 28734 or drop off at the Macon County Community Building.
Silver Arts – Visual, Heritage, Literary and Performing
The Silver Arts exhibit will be held in the Macon County Community Building, 1288 Georgia
Road. We encourage everyone to view these pieces of work May 3rd thru May 5th between the
hours of 10 and 4. Entries are due at the Comm. Bldg. April 30th from 12:00pm & 2:00pm.
Our performing arts category, competition will be in conjunction with the Banquet.
State Finals
Participants may qualify for the NC Senior Games State Finals by placing 1st, 2nd, or 3rd in our local games, except in the performing arts category in which only the 1st place winner is eligible. It is the participant’s responsibility to check with your local Games to determine if you are eligible. It
is also your responsibility to pick up your State Final form and return it to the State Games by
August 1, 2016 by 5:00 p.m. No one can do this for you. It is your responsibility.
Official Entry Form
Must be filled out signed and returned by April 20st 2016
Registration Fee $20.00
Men 50-54 55-59 60-64 65-69 70-74 75-79 80-84 85+
Women 50-54 55-59 60-64 65-69 70-74 75-79 80-84 85+
(Please circle age group you are in as of December 31, 2015)
Please Print: (A participant must be a North Carolina resident for a minimum of 3 consecutive months of the year.)
NAME______Male______Female_____
Macon County Address______Age______
City/State/Zip______
Date of Birth______
Macon Co. Phone #______
Shirt Size: (Circle One) Sm. Med. Lg. XLg. XXLg.
E-mail Address: (Please Note that NCSG is asking for this information at the State Level)
Email______
If you live out of town in the winter months please fill out below:
Winter Address: ______
City/State/Zip: ______
Winter Phone # ( )______
Please provide this info to help us. It will be kept confidential. Thank you!
My ethnicity: _Black or African American; Asian; American Indian or Alaska Native; White;
Native Hawaiian or other Pacific Islander; Hispanic;or Unknown/Refused..
My annual household income is less than $11,670 (1 person in household) _ Yes
My annual household income is less than $15,730 (2 people in household) _ Yes
No response __.
“To qualify for State Finals, golfers need to meet a minimum performance score (MPS) and finish in the top 3 in their age group.” MPS available from your coordinator.
“To promote total health and physical fitness, events of longer duration and lower intensity are strongly recommended. High-intensity types of activities are offered primarily for the conditioned, trained athlete.”
Name______How many years have you participated in the games?______
Age_____ Male____ Female____ Phone Number______
For Bracketed Events Roll call will be 10 minutes before start time. If you are not present at Roll Call you will forfeit the event. THERE WILL BE NO EXCEPTIONS.
Please indicate the events in which you would like to participate by marking with an X.
___Banquet How many guests? ______Amount for Guest ($10.00 each) ______
_____Archery Recurve Bare Bow_____Archery Recurve with site
_____Archery Recurve with Site & Release
_____Archery Compound Bare Bow
_____Archery Compound with Site
_____Archery Compound with Site & Release
_____Badminton Doubles______partner
_____Badminton Mixed Doubles ______partner _____Badminton Singles
_____Basketball Shooting
_____Billiards
_____Bocce Doubles (fun game)______partner
_____Bocce Mixed Doubles (fun game)______partner
_____Bocce Singles
_____Bowling Doubles ______partner
_____Bowling Mixed Doubles ______partner
_____Bowling Singles
_____Bridge (fun)______partner _____Corn Hole doubles (fun) ______partner
_____Corn Hole mixed doubles (fun)______partner
_____Corn Hole Singles
_____Croquet
_____Cycling 1K
_____Cycling 5K
_____Cycling 10K
FIELD EVENTS
_____Discus
_____Running Long Jump
_____Shot-put
_____Standing Long Jump
_____Football Throw
_____Golf – Additional cost
_____Horseshoes Mixed doubles______partner
_____Horseshoes Singles
_____Pickle ball Doubles ______partner
_____Pickle ball Mixed Doubles______partner
_____Pickle ball Singles
_____Racquetball
_____Shuffleboard doubles (fun)______partner
_____Shuffleboard Mixed doubles (fun)______partner
_____Shuffleboard Singles
_____Silver Striders fun walk / _____Softball Throw
_____Spelling Bee (fun)
_____Spin Casting
_____Table Tennis Doubles ______partner
_____Table Tennis Mixed Doubles ______partner
_____Table Tennis Singles
_____Tennis Doubles ______partner
_____Tennis Mixed Doubles ______partner
_____Tennis Singles
SWIMMING
_____100 yd. Backstroke
_____100 yd. Breaststroke
_____100 yd. Butterfly
_____100 yd. Free
_____100 yd. Medley
_____200 yd. Backstroke
_____200 yd. Breaststroke
_____200 yd. Butterfly
_____200 yd. Free
_____200 yd. Medley
_____50 yd. Backstroke
_____50 yd. Breaststroke
_____50 yd. Butterfly
_____50 yd. Free
_____500 yd. Free
TRACK
_____100 M Dash
_____1500 M Racewalk
_____1500 M Run
_____200 M Dash
_____400 M Dash
_____5 K Racewalk
_____800 M Run
_____5K Run
_____Performing Arts (please fill out additional form)
_____Silver Arts (please fill out additional form)
(fun) games are not official State games.
This must be attached with the Senior Games Application Form
Silver Arts Official Registration
Please circle (category) of entry and write a full description of entry
Visual Art
Categories (circle one) Oil, Acrylics, Mixed Media, Watercolor, Pastels, Drawing, Sculpture, Photography
Limit one per category
(Describe) Title of art description age completed
____________
Heritage Arts
categories (circle one) Quilting, Weaving, Tatting & Needle lace, Crocheting, Knitting, Rugs (hooked, braided, woven), Basket Weaving, Pottery – Hand built & thrown, Woodworking, Woodcarving, Woodturning, Needlework, Jewelry, China Painting, Stained Glass & Tole Painting
(Describe) Title of art description age completed
______
Literary Arts
Categories (circle one) Essays, Life Experiences (Autobiographical), Poems & Short Stories
Limit Two (Must be different Category)
(Describe) Title of art description age completed
______
Performing Arts
Categories (circle one) Dance, Vocal, Instrumental, Comedy & Drama, Cheerleading
Limit 2 – (1 Act in 2 different category)
Title of song/act______
Names of participants
______
______
______
Are you a Competing act?______Are you a Non competing act?______
Entry is limited to 3 minutes. This is one of the judging points as well as DIFFICULTY, ORIGINALITY, SKILL & SHOWMANSHIP. Props are pe rformer’s responsibility. Voice presentations must be live. Background music can be taped.
These are the standards used by the State finals in Raleigh.
Non competing acts also must not exceed 3minutes
DELIVER SILVER ARTS ON April 30th FROM 12:00 TO 2:00 ONLY
PICKUP SILVER ARTS ON MAY 5th FROM 2:00 TO 4:00
Liability Waiver
I understand, that although every effort will be taken to insure proper care of art work submitted, The Macon County Senior Games or associated organizations are not liable for loss, theft or damage to work.
STATE FINALS “I understand that it is my responsibility to check with my local Senior Games Coordinator
immediately following my local Senior Games to determine if I qualified for State Finals and to get a
State Finals Entry Packet if I do not have internet access. My State Finals registration with payment
and all required items must be received in the NCSG office in Raleigh by 5:00 p.m. on August 1st!
I understand that this deadline is strictly enforced in fairness to all and it is my responsibility to make sure I am registered.”
Health & Emergency Information
The staff of the Macon County Senior Games is committed to creating a healthy and safe environment for all participants. To promote total health and physical fitness, events of longer duration and lower intensity are strongly recommended. High-intensity types of activities are offered primarily for the conditioned, trained athlete. Please complete the following information. Please Print.
List any Medications that you are currently taking: ______
______
List any specific health conditions or problems that you have: ______
______
Name of Physician and office number: ______
Emergency contact person and phone number:______
PLEASE READ AND SIGN THE WAIVER BELOW: THIS IS A REQUIREMENT!!!!!
I, the undersigned participant, hereby agree to indemnify, save and hold harmless the Macon County Recreation Park, Macon County Senior Games, North Carolina Senior Games, Inc., Mill Creek Country Club, Franklin Lanes, Franklin Health and Fitness Center, Holly Springs Babtist Church hall, and Franklin High School or any of their agents, sponsors or representatives for my health, safety, or any injury resulting from my participation in the Macon County Senior Games Program.
I have prepared myself for the events, which I have entered by practice prior to the actual competition. To the best of my knowledge and belief, I have no physical restrictions, which would prohibit my participation in the events that I have selected. I have been advised by the Macon County Senior Games Coordinators that it would be in my best interest to consult with my physician prior to my preparation for actual participation in the events of my choice. The Macon County Senior Games Coordinators have my permission to have a physician/EMT attend me if it is deemed necessary during my participation in the Macon County Senior Games Program. I am covered by hospitalization or medical insurance through private carrier, Medicare, Medicaid or otherwise which provides for the payment for health care benefits for illness or injury from my participation in the Senior Games.
The undersigned has read the above waiver and release and understands that they have given up substantial rights by signing it and voluntarily sign it. I have read this waiver/release.
______
Signature Date
MONDAY APRIL 25th10;30 am OPENING CEREMONIES & covered dish lunch
1:00 pm pickleball singles (official)
1:00 pm shuffleboard *(fun) – men’s doubles
1:00 pm bocce *(fun) – women’s doubles
3:00 pm cornhole* (fun) -- mixed doubles
TUESDAY APRIL 26th
9:00 am pickleball doubles (official)
11:00 am shuffleboard* (fun) – women’s doubles
10:00 am bocce *(fun) – men’s doubles
10:00 am horseshoes * (fun) mixed doubles
WEDNESDAY APRIL 27th
9:00 am pickleball mixed doubles (official)
11:00 am shuffleboard *(fun) – mixed doubles
1:30 pm corn hole - women 70-74
1:30 pm corn hole -- men 50-74 & 80+
THURSDAY APRIL 28th
8:30 am run -- 800 meter – at FHS track
9:30 am horseshoes – men 50-74
9:30 am shuffleboard – women 70-74
9:30 am bocce – men 75-79
4:00 pm croquet all*(fun) at softball field
FRIDAY APRIL 29th
9:00 am table tennis - all – at Comm. Bldg. gym
10:00 am shuffleboard – men 70-74 & 80+
10:30 am bocce – women 70-74
10:30 am horseshoes -- women
SATURDAY APRIL 30th
12:00pm to 2:00 pm Drop off Silver arts at comm bldg..
8:30 am race walk -- 1500 meter – at FHS track
9:00 am dashes – 400, 200, & 100 meter
9:30 am fun walk
10:00 am long jumps, discus, shot put & spin casting
MONDAY MAY 2nd
900 am tennis – all
9:00 am billiards -- men - at Franklin Lanes
10:00 am billiards – women – at Franklin Lanes
1:00 pm bowling – doubles – at Franklin Lanes
TUESDAY MAY 3rd
Tuesday–Wednesday view silver arts at comm. Bldg
8:30 am breakfast for all sr. games participants
10:00 am – 2:00 pm HEALTH FAIR
2:00 pm shuffleboard -- women 50-64 & 80+
2:00 pm bocce -- men 50-64, 65-74 & 80+
WEDNESDAY MAY 4th
9:00 am bocce -- women 80+
9:30 am horseshoes -- men 75-79 & 80+
9:30 am bocce – women 75-79
1:00 pm rained out events / THURSDAY MAY 5th
9:00 am swimming -at Franklin Health & Fitness Ctr.
If you are swimming long events, you can get someone
to time you earlier; otherwise you will swim at this time
9:00 am to Noon - pickup silver arts
10:00 am shuffleboard – men 50-69 & 75-79
10:00 am bocce (fun) – mixed doubles
1:00 pm rained out events
FRIDAY MAY 6th
8:30 am race walk – 5K – at FHS track
10:00 am shuffleboard women 75-79
1:00 pm bowling--singles–-at Franklin Lanes
MONDAY MAY 9th
8:00 am golf – at Mill Creek Golf Course
8:30 am 5K run - at Franklin High school track
9:30 am bocce – women 50- 69
1:00 pm basketball shoot – at Comm. Bldg. gym
2:00 pm softball throw-at softball field
2:30 pm football throw - at Comm. Bldg gym
4:00 pm croquet - men-at softball field
TUESDAY MAY 10th
9:00 am badminton – singles & mixed doubles
10:00 am Bingo
11:30 am spelling bee*(fun)--at Comm. Bldg. meeting room
12:30 pm PRESIDENTS LUNCH
1:30 pm corn hole men 75-79
4:00 pm croquet- women–at softball field
WEDNESDAY MAY 11th
8:30 am run – 1500 meter – FHS track
9:00 am corn hole – women 50-69,75-79 & 80+
1:00 pm bowling mixed doubles
THURSDAY MAY 12th
8:00 am cycling – all
9:30 am badminton - doubles
10:30 am shuffleboard – women 65-69
1:00 pm rained out events
FRIDAY MAY 13th
SATURDAY MAY 14th
9:30 am Archery
6:00 pm Banquet – at Holly Springs Church Hall
TUESDAY MAY 17th
10:30 am bingo
12:00 am covered dish lunch, recognize medal winners, and pickup state registration forms
DATES TO BE ANNOUNCED
bridge racket ball rest home games
*(fun) games not age grouped 1st ,2nd, & 3rd only
2016 SCHEDULE OF EVENTS final