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SAN JUAN COUNTY SENIOR OLYMPICS 2013 (MEN and WOMEN 50+) APRIL 2 - MAY 3, 2013 SPONSORED BY: BP America Production Company • The City of Farmington’s Parks, Recreation, & Cultural Affairs Department ENTRY FEE: $7.00 - Paid by All Participants: Entry Fee Covers ALL Events entered, including Dance, Awards Picnic, + T-Shirt. SENIOR OLYMPIC T-SHIRT will be YOUR PASS to ALL Events. NM State Olympics, Roswell, June 12 - 16, 2013 PERSONAL INFORMATION: (Please Print Clearly) Name: Address: City: Zip: Telephone: Home: Alternate Date Of Birth: Age: (as of Dec. 31, 2013): *Tournament Director reserves the right to combine Age Groups according to the number registered for each event. Check One: MALE FEMALE EMERGENCY CONTACT: Name: Relationship: Phone: LIABILITY WAIVER: San Juan County Senior Olympics strongly recommends that each participant consult his/her doctor in regard to practice, preparation, and competition in this program or any similar activity. I, THE UNDERSIGNED, IN CONSIDERATION OF BEING PERMITTED TO PARTICIPATE IN THE SENIOR OLYM- PICS, EXECUTE THIS RELEASE IN FAVOR OF THE SAN JUAN COUNTY SENIOR OLYMPICS PLANNING COM- MITTEE, SPONSORS OR ANY OF THEIR AGENTS OR REPRESENTATIVES WITH THE INTENT OF BINDING MYSELF, MY SPOUSE, MY HEIRS, LEGAL REPRESENTATIVES, AND ASSIGNS. I HEREBY RELEASE AND FOREVER DISCHARGE SPONSORS, THEIR OFFICERS AND EMPLOYEES FROM ANY CLAIM INCLUDING BUT NOT LIMITED TO ANY COSTS AND ATTORNEY’S FEES ARISING FROM ANY BODILY INJURY, DEATH OR PROPERTY DAMAGE RESULTING FROM ANY ACCIDENT WHICH MAY OCCUR AS A RESULT OF MY PARTICIPATION IN THE SENIOR OLYMPICS WHETHER BY NEGLIGENCE OR NOT. TO THE BEST OF MY KNOWLEDGE AND BELIEF, I HAVE NO PHYSICAL RESTRICTION WHICH WOULD PROHIBIT MY PARTICIPATION IN THE EVENTS THAT I HAVE SELECTED. I GIVE MY PERMISSION TO HAVE A PHYSICIAN ATTEND ME IF IT IS DEEMED NECESSARY DURING MY PARTICIPATION IN THE OLYMPICS. SIGNATURE DATE: Parks, Recreation, and Cultural Affairs Bonnie Dallas Senior Center 109 E. LaPlata St. (505) 599-1380 • www.fmtn.org/prca SAN JUAN COUNTY ---PAGE BREAK--- TUESDAY, APRIL 2. BASKETBALL FREE THROW: 9:00 am, Farmington Recreation Center, 1101 Fairgrounds Rd., Farmington THURSDAY, APRIL 4. CANASTA : “Hand & Foot”: Partners, No Age Brackets - 9:00 am , Senior Center Annex, 208 N. Wall, Farmington Partner’s Name FRIDAY, APRIL 5. PINOCHLE TOURNAMENT: No age Brackets - 9:00 am, Aztec Senior Center MONDAY, APRIL 22. PARTY BRIDGE: No Age Brackets - 12:30 pm, Senior Center Annex, 208 N. Wall, Farmington Partner’s Name TUESDAY, APRIL 9. “42” TOURNAMENT: Partners - No Age Brackets - 9:00 am, Bloomfield Cultural Center. (Bring Dominoes) THURSDAY, APRIL 25. TENNIS: 1:30 pm, Farmington Lions Pool Tennis Courts, 405 N. Wall, Farmington (Bring 1 Can of New Balls) Singles Doubles: Partner: Mixed Doubles: Partner: BOWLING TOURNAMENT: 9:00 am, Bowlero Lanes, 3704 E. Main St., Farmington MONDAY, APRIL 29. DUPLICATE BRIDGE: No Age Brackets - 12:30 pm, Senior Center Annex, 208 N. Wall, Farmington Partner’s Name WEDNESDAY, APRIL 10. TABLE TENNIS: 1:30 pm, Farmington Recreation Center, 1101 Fairgrounds Rd., Farmington Singles Doubles: Partner: Mixed Doubles: Partner: MONDAY, APRIL 15. CRIBBAGE: No Age Brackets : 1:00 pm, Senior Center Annex, 408 N. Wall, Farmington FRIDAY, APRIL 26. FIELD DAY AND ESTIMATED TIME RACES. FIELD DAY: 9:00 am, Kiwanis Park, 30th & Main, Farmington. Softball Distance Throw. Soccer Kick. Frisbee Disc: Distance Throw. Frisbee Disc: Throw of Accuracy. WALK RACES: 9:00 am, Kiwanis Park, 30th & Main, Farmington. 400 Estimated Run/Walk 800 Estimated Run/Walk SATURDAY, APRIL 20. ARCHERY: 9:00 am, San Juan Archery Range. TUESDAY, APRIL 23. SHUFFLEBOARD: Doubles - 9:00 am, Farmington Recreation Center, 1101 Fairgrounds Rd., Farmington Partner’s Name WEDNESDAY, APRIL 17. CROQUET: No age Brackets - 9:00 am, Bloomfield Cultural Center WEDNESDAY, APRIL 24. GOLF :9 - Holes: 8:30 am, Civitan Golf Course, 2100 N. Dustin, Farmington FRIDAY, APRIL 19. SWIM DAY: 1:30 pm, Lions Pool, 405 N. Wall St., Farmington BACK STROKE: 50 Yards 100 Yards FREE STYLE: 50 Yards 100 Yards BUTTERFLY: 50 Yards 100 Yards BREAST STROKE: 50 Yards 100 Yards ESTIMATED LAP SWIM LONGEST FLOAT CONTEST SATURDAY, APRIL 13. CYCLING: 8:00 am, Bloomfield High School. For More Information, Contact Norm Tucker: 632-8351 1600 M 5K 10K TRACK: 9:00 am, Bloomfield High School. 50M RUN 1500M RUN 400M RACE WALK 100M RUN 3000M RUN 1500M RACE WALK 200M RUN DISCUS 3000M RACE WALK 400M RUN JAVELIN STANDING LONG JUMP 800M RUN SHOT PUT HIGH JUMP LONG JUMP TUESDAY, APRIL 30. SHUFFLEBOARD: Singles - 9:00 am, Farmington Recreation Center, 1101 Fairgrounds Rd., Farmington WEDNESDAY, MAY 1. HORSESHOES: Civitan Golf Course Courts, 2100 N. Dustin, Farmington (Bring Horseshoes) Singles: 9:00 am Doubles: 10:30 am Partner’s Name TUESDAY, APRIL 16. ____DOMINOES TOURNAMENT: Partners:No Age Bracket: 9:00 am, Bloomfield Cultural Center.(Bring Dominoes) FRIDAY, MAY 3. AWARDS PICNIC and FUN RELAYS, 10:00 am, Bonnie Dallas Senior Center, 109 E. La Plata St., Farmington Potato Carrying Relay - No Age Brackets : 4 persons per team : Men or Women Balloon Popping Relay - No Age Brackets: 4 persons per team : Men or Women If you desire an event not listed, that the State of New Mexico offers, or for more information call the Bonnie Dallas Senior Center: 599-1380 BADMINTON: 1:30 pm, Tibbetts Middle School, 312 E. Apache, Farmington Singles Doubles: Partner: Mixed Doubles: Partner: WEDNESDAY, APRIL 3. MINIATURE GOLF: 10:30 am, Big Bounce/Teddy Connection, 3050 E. 20th St., Farmington THURSDAY, APRIL 18. FRIDAY, APRIL 12. POOL TOURNAMENT: 8:30 am, Bonnie Dallas Senior Center, 109 E. La Plata St., Farmington SATURDAY, APRIL 6. DANCE COMPETITION: No Age Brackets: 7:00 pm, Senior Center Activity Center, 208 N. Wall, Farmington THURSDAY, APRIL 11. AIR RIFLE: 10 Meter Standing 10 Meter Bench Rest AIR PISTOL: 10 Meter Standing 10 Meter Bench Rest 1:30 pm, San Juan Wildlife Range. Contact Wayland Moore: 326-0773 MONDAY, APRIL 8. Call Joan Arviso: 215-3047 (Bring Your Own Bows) (Bring Your Own Guns, Pellets, & Targets) Put Your Little Foot Western 2-Step “If this is Love” Jitterbug, “In the Mood” Ballroom Waltz “Edelweiss” Polka “Hoop Dee Doo” Western Waltz “Teach Me to Dance” Cha Cha Cha “Wheels”