Registration Form

CELEBRATING 35 YEARS OF FUN
ARCHERY
BASKETBALL
BILLIARDS
BOCCE
BOWLING
CORNHOLE
CUP STACKING
DISC GOLF
FOOTBALL TOSS
GOLF
GOLF CHIPPING
HORSESHOES
KOOB
MINIATURE GOLF
PICKLE BALL
POP-A-SHOT
SHUFFLEBOARD
SKITTLES
SOFTBALL HITTING
SOFTBALL THROW
SPIN CASTING
TENNIS
WASHER TOSS
And more...
Monday, May 8
Friday, May 12
Tower Park — Ft. Thomas
8:00 AM — Registration Opens
8:30 AM — Games Begin
Shuffleboard — Skills Contest
Basketball Spot Shooting
Pop-A-Shot
3 Hole Miniature Golf
Billiards — Shooting Contest
Cup Stacking
Corn Hole Toss
Washer Toss
Skittles
12:00 PM — Games Close
12:15 PM — Torch Lighting
12:30 PM — Lunch*
Boone Woods — Burlington
9:30 AM — Games
Archery
3 Hole Disc Golf
Golf Chipping
Softball Hitting Contest
Softball Throw
Horseshoe Toss
Football Toss
Spin Casting
Koob
12:00 PM — Lunch and Awards
*Awards will be presented during lunch.
Tuesday, May 9
World of Golf — Florence
8:00 AM — 9 Hole Golf Tee Times begin
Participants will be notified of tee times
after 1:00 PM Monday, May 8
DO NOT CALL the course.
Optional—Golf cart fee of $8.50 per person.
Payable at tee time.
Walt’s Center Lanes — Newport
10:00 AM — Bowling — Singles
There is a one time fee of $7 for all Bowling events
Wednesday, May 10
Golf Courses of Kenton County
7:30 AM — 18 Hole Golf Tee Times begin
Monday, May 15
Five Seasons — Crestview Hills
9:00 AM — Women’s Tennis Doubles
(Participants should have experience playing tennis)
Tuesday, May 16
Boone Woods — Burlington
6:00 PM — Bocce Tournament
Wednesday, May 17
Five Seasons — Crestview Hills
7:30 AM — Pickle Ball
10:00 AM — Men’s Doubles Tennis
(should have experience playing tennis and/or pickle ball)
Thursday, May 18
Five Seasons—Crestview Hills
11:00 AM — Mixed Tennis Doubles
(Participants should have experience playing tennis)
Participants will be notified of tee times
after 1:00 PM Tuesday, May 9
Monday, May 22
DO NOT CALL the course.
Maplewood Gym (by fairgrounds) - Burlington
9:00 AM — Shuffleboard Tournament
Required—Golf cart fee of $16 per person.
Payable at tee time.
Thursday, May 11
Walt’s Center Lanes — Newport
8:45 AM — Registration opens
9:00 AM — Men’s & Women’s Doubles Bowling
There is a one time fee of $7 for all Bowling events
11:45 AM — Check In
12:00 PM — Mixed Doubles Bowling
There is a one time fee of $7 for all Bowling events
Wednesday, May 24
Maplewood Gym (by fairgrounds) - Burlington
1:00 PM—Cornhole Tournament
Wednesday, May 31
Maplewood Gym (by fairgrounds) - Burlington
1:00 PM—Washer Toss Tournament
Wednesday, June 7
Boone Woods Shelter #3 - Burlington
1:00 PM—Koob Tournament
AGE REQUIREMENTS
Age bracket will be
determined by
participant's age as of the
date of the event.
Participants must be 50
or older before May 8,
2017. Competition will be
held by age bracket as
requirements allow.
Please note that due to scheduling conflicts, games cancelled
due to weather conditions will not be rescheduled and
no refunds will be given.
Local participation is not required to qualify for the State games;
However, you are encouraged to participate at the
Kentucky State Senior Games in Frankfort, Kentucky.
(Information 502-320-2264 or www.kentuckyseniorgames.com)
RULES
Kentucky State Games
official rules will be
followed with Northern
Kentucky Senior Games
modifications.
AWARDS
Senior Games Awards
will be presented to the
1st, 2nd, and 3rd place
finishers in each event in
each age group for both
Men and Women.
INFORMATION
For additional information or
to get a registration form
call:
Northern Kentucky
Area Development District
859-283-1885
Fort Thomas Recreation Dept.
859-781-1700
Boone County Parks
859-334-2117
Kenton County Parks
859-525-PLAY
Paul Ankenbauer ........................... Chairman, Boone County Parks
Mary Ann Neltner ............................................ Boone County Parks
Kat Disney .............................. Fort Thomas Recreation Department
Rhonda Ritzi .............................Kenton County Parks & Recreation
Erin Smiley …………………………...Covington Parks & Recreation
Dee Neary ................ Northern Kentucky Area Development District
Raymond Sonoff .......................................... .Senior Representative
Nita Brake ............................................... Independence Recreation
Michelle Frisch .................................................... City of Edgewood
Monica Braunwart ........................................................ St. Elizabeth
Kim Wagner……………………….…….……...Alexandria Recreation
Kim Wolking…………………………….………..…….City of Erlanger
Rhonda Chisenhall…………....NKY Community Action Commission
ENTRY FORM
Name: ______________________________________________________________Age: ________ Birth Date: _______________Sex: M F
(please print) First
Last
Address: ________________________________________City: ______________________State: ______Zip:_________County:_________________
Shirt Size: S M L XL 2XL 3XL 4XL
First time participant?
Yes
Primary Phone# ______________________ Secondary Phone #______________________
No
Email:_________________________________________________
Place a check next to the days/events that you plan on
attending. Please refer to the schedule to verify times as
some events have conflicting times and you cannot
compete in both.
Monday, May 8
(all events & lunch included in base entry fee)
Tuesday, May 9
Golf — World of Golf — Florence (included in base entry fee)
____ 9 Hole (Add’l $8.50 per person golf cart fee optional at course)
(included in base entry fee)
Maplewood Gym (by Fairgrounds) — Burlington
____ Shuffleboard tournament.
__________________________________________
__________________________________________
Wednesday, May 24
Bowling — Walt’s Center Lanes — Newport (Extra Fee)
____ Singles (there is a one time fee of $ 7 for all 3 bowling events)
(included in base entry fee)
Maplewood Gym (by Fairgrounds) - Burlington
____Cornhole Tournament
Wednesday, May 10
Wednesday, May 31
Golf Courses of Kenton County (included in base entry fee)
____ 18 Hole (Add’l $16 per person golf cart fee required at course)
Name of Partners:
(included in base entry fee)
Five Seasons—Crestview Hills
(Participants should have experience playing tennis)
_____ Mixed Tennis Doubles—Partner____________________
Monday, May 22
__________________________________________
(included in base entry fee)
Five Seasons — Crestview Hills
(Participants should have experience playing tennis/pickle ball)
____ Men’s Doubles Tennis—Partner____________________
_____ Pickle Ball
Thursday, May 18
____Tower Park — Ft. Thomas
Name of Partners:
Wednesday, May 17
(included in base entry fee)
__________________________________________
Maplewood Gym (by Fairgrounds—Burlington
_____Washer toss Tournament
__________________________________________
Wednesday, June 7
Thursday, May 11
(included in base entry fee)
Boone Woods Shelter #3—Burlington
_____Koob Tournament
__________________________________________
(Extra Fee)
Bowling — Walt’s Center Lanes — Newport
____ Men Doubles (There is a one time fee of $7 for all 3 bowling events)
Name of Partner:______________________________________
____ Women Doubles (There is a one time fee of $7 for all 3 bowling events)
Name of Partner:______________________________________
____ Mixed Doubles (There is a one time fee of $7 for all 3 bowling events)
Name of Partner:______________________________________
Friday, May 12
Plus $ 10, if you are mailing after May 1 ... +$ _______
(included in base entry fee)
Five Seasons — Crestview Hills
(Participants should have experience playing tennis)
____ Women’s Tennis Doubles—Partner_____________________
(included in base entry fee)
Boone Woods — Burlington
____ Bocce tournament.
.................................................. +$ _______
if you do not live in one of the following Kentucky counties listed:
Kenton, Campbell, Boone, Pendleton, Grant, Owen, Gallatin, Carroll
_____Boone Woods — Burlington
Tuesday, May 16
(one time fee for all 3 bowling events)
Plus $ 10,
(all events & lunch included in base entry fee)
Monday, May 15
Plus $ 7, if you are bowling: ...................... +$ _______
TOTAL:
.................................. =$ _______
Make check payable to:
Northern KY Senior Games
SORRY NO REFUNDS
SORRY NO CREDIT CARD PAYMENTS
Complete this entire form/page, sign it and return with your entry fee to:
Boone County Parks, PO Box 566 Burlington, Kentucky 41005
Pre-Registration Deadline is May 1. (SHIRT NOT GUARANTEED AFTER DEADLINE)
In consideration of the granting of this request to enter the Northern Kentucky Senior Games, I for myself, my heirs and administrations, waive and release any
and all claims against any and all participating sponsors for all claims and damages, actions whosoever in any manner as a result of my participation in said
Northern Kentucky Senior Games. I attest and verify that I am physically fit and have sufficiently trained for the competition of this event, and my physical condition has been verified by a licensed medical doctor. I also hereby consent to the use of my photograph or cinematic image without compensation.
Signature _______________________________________Date: ______________________
Emergency Contact: _____________________Relationship: _______________________Emergency Phone: _________________________
DO NOT CUT!
Return entire completed page.
Boone County Parks
PO Box 566
Burlington, Kentucky 41005
FUN, FITNESS, COMPETITION, AND CAMARADERIE
The Northern Kentucky Senior Games is an event for
Northern Kentuckians ages 50 and over to engage in spirited competition
and exercise through many different games and events.
BOWLING, TENNIS, GOLF, HORSESHOES, SOFTBALL TOSS,
BASKETBALL, BOCCE, BILLIARDS, MINIATURE GOLF,
ARCHERY AND CORN HOLE ARE JUST A FEW OF THE
ACTIVITIES OFFERED.
SPONSORS
KY Cabinet for Health and Family
Services/NKY Area Agency on
Aging and Independent Living
Interim Healthcare
_____________________________________________________________________
Barrington and Highlandspring of Fort Thomas
St. Elizabeth Healthcare - PrimeWise
Humana
Chick-fil-A
ClearCaptions
Baptist Life Communities
_________________________________________________
SENIOR GAMES
OATH
Today the Joy of
Competition
calls me to the test.
I have the
opportunity to strive
to reach my best. I
have learned with
age that effort is the
only true first place;
there is victory in
accepting challenge
and in trying, there is
grace.
Marian Sizemore, State Farm Insurance
Northern Kentucky Physical Medicine
Cash Express—Elsmere
EVENT HOSTS
City of Florence/World of Golf
Golf Courses of Kenton County
Tower Park—Fort Thomas
Walt’s Center Lanes—Newport
Five Seasons Sports Country Club
Boone Woods Park—Boone County