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North Idaho Senior Games On-Line Registration

(2009 Registration Deadline is June 1st ) 

For a mail-in registration form, click here.
Print out the PDF form and mail it to:
NISG
Parks and Recreation
1424 Main Street
Lewiston, IS 83501

Completed registration forms (either paper or online)
must be received on or before June 1st.

 

After submitting the requested information a confirmation will be emailed back to you.

 
Please provide the following contact information:
Participant Information
Last Name
First Name
Group Name
Street Address
City
State/Province
Zip/Postal Code
Home Phone
Work Phone
FAX
E-mail
Gender
Male    Female
Birthdate
T-Shirt Size
Small   Medium    Large    XLarge    XXLarge
(If you are registering as a group you will need to email additional shirt sizes and quantity to Administrator@northidahoseniorgames.org)
Emergency Contact Information
Emergency Contact
Phone
Relationship
 


Select the Event(s) in which you wish to participate:


5K Run/Walk
  Run   
  Walk
Archery
  Traditional   
  Compound
Bowling
  Singles   
  Mixed Doubles -- Partner's Name:
Cycling
  10K Time Trial
Golf
  18 Hole Scratch Play
Horseshoes
  Singles
Pickleball
  Singles   
  Doubles -- Partner's Name:
  Mixed Doubles -- Partner's Name:
  Open Doubles -- Partner's Name:
Kick-Off Picnic
  Yes
Putting
  18 Scratch Play

Raquetball

  Singles
Swimming 
  Freestyle 50m   Freestyle 100m  
  Backstroke 50m Backstroke 100m Backstroke 200m
  Breaststroke 50m   Breaststroke 100m Breaststroke 200m
  Butterfly 50m Individual Medley 100m  
Table Tennis
  Singles
  Open Doubles -- Partner's Name:
Tennis
  Singles
  Doubles -- Partner's Name:
  Mixed Doubles -- Partner's Name:
Track & Field (Maximum of 6 events)
  60m   100m    200m    400m    800m    1600m    5k Race Walk
  Shot    Discus    Javelin    Softball    Long Jump    Standing Long Jump


Payment Calculation & Wavier


Registration Fee - Indicate below whether you are registering for one sport or multiple sports, and which fees apply to golf and bowling events
One Sport
 
$15.00
Multiple Sports  
$25.00
Bowling: Per 3 game set 6.00
Golf: Incl fees & ½ cart rental For those with no membership at Bryden Canyon club 25.00
Golf: For cart rental, Bryden Canyon Club member 11.50
Golf: No charge, Bryden Canyon Club member who owns cart 0.00
Putting: 4.00

Non-participant - Special Event Fees ( in addition to the Registration Fee) -
Please check all that apply
Extra T-Shirt
for non-participant
$8.00

S   M   L   XL   XXL
Picnic Fee for non-participant
$5.00
Donation to benefit future NISG events
$
 

 

PARTICIPANT WAIVER

I the undersigned, enter into this agreement in consideration of being permitted to participate in North Idaho Senior Games and/or enter into for any purpose any restricted area (herein defined as the area to which admission by general public spectators is prohibited and in addition consisting of the planned route, or any other area which the participant chooses to access by any mode of transportation), or being permitted to compete, officiate, observe, work for, or for any purpose participate in anyway in the North Idaho Senior Games. By entry of this agreement, I represent warrant and covenant as follows:

1.        I warrant and represent that I am in good physical health and condition and I am physically able to compete in any events I have selected. I know of no physical restrictions whatsoever which would prohibit my participation in the events I have selected. I am of sound mind, free of legal disability and capable of binding entry into this agreement. I have been advised that it would be in my best interest to consult my physician prior to my preparation in regard to participation in the North Idaho Senior Games. I recognize and understand that the preparation and completion may necessitate strenuous physical activity, and could possibly activate any unrecognized pre-existing medical conditions including but not limited to cardiovascular disorder which I may have, thereby resulting in serious or life threatening harm to me.

2.         I hereby release, waive, discharge, covenant not to sue, agree to indemnify and hold harmless the North Idaho Senior Games and promoters, sponsors, advertisers, hosts, operators, officials, other participants and any persons in a restricted area, owners and lessees of premises used to conduct the events and each of them, their respective administrators, officers, directors, and employees (collectively referred to herein as “released parties”) from any and all actions, causes of action and any claim or demand whatsoever of any kind or nature on account of injury to person or property or resulting in death of, or injury to the undersigned which I, my representatives, heirs, from any and all actions, causes of action and any claim or demand whatsoever of any kind or nature on account of injury to person or property or resulting in death of, or injury to the undersigned which I, my representatives, heirs, next of kin or assigns may have or at anytime in the future have as a result of my participation in the North Idaho Senior Games,  whether caused by the negligence of the released parties or other wise while the undersigned is in or upon the restricted area and/or competing, officiating, observing, or working for, or for any other purpose participating in the North Idaho Senior Games. I further agree that I shall hold the released parties harmless from and indemnify each of them from any loss, liability, damage, or costs including attorney fees that they may incur arising from claim made by or through the undersigned.

3.        I hereby assume full responsibility for and risk of bodily injury, death or property damage due to the negligence of the parties released or otherwise while in or upon the restricted area and/or while competing, officiating, observing or working for, or any purpose participating in the North Idaho Senior Games. I expressly acknowledge and agree that the activities at the North Idaho Senior Games and entry into the restricted areas involved an element of danger and risk of serious and/or property damage. I have or will immediately upon entering any of such restricted areas, and will continuously thereafter inspect such restricted area or areas and all portions thereof which I enter and with which I have contact, and further warrant that my entry upon such restricted areas and participation, if any, in the event constitute an acknowledgment that I have inspected such areas, find and accept same to be safe and reasonable suited for the purpose of my use. I further agree and warrant that if at anytime while in or about restricted areas or participation in any event, I feel anything to be unsafe, I will immediately advise the officials of such and will leave the restricted area or cease participation in the event.

4.        In the event that I sustain injury or illness while participating in the North Idaho Senior Games or while being in a restricted area, I hereby authorize and permit any emergency, first aid, medication, medical treatment or surgery deemed necessary by licensed medical personnel. I also give my permission for attending medical personnel to execute on my behalf any permission forms or other necessary medical documents and to act on my behalf if I am not immediately available to do so. The name and phone number of the person whom I wish to have contacted in such an emergency is listed below.

5.        I hereby give my permission to the North Idaho Senior Games, its sponsors and agents, to use or publish photography taken of me during the North Idaho Senior Games, or to use my name in connection therewith, without any remuneration, in any advertising promotional materials they may prepare and utilize in the promotion of the North Idaho Senior Games.

6.        This waiver, release and indemnification agreement specifically embraces each and every sport event sanctioned, authorized or promoted by the released parties during the entire North Idaho Senior Games and applies to each and every sport or activity and has the same effect as if executed after each and every activity or sport in which the undersigned so as the parties herein intended to be released and indemnified shall be fully and effectively released and indemnified as to each and every such sport.

 THIS AGREEMENT CONTAINS A RELEASE AND SHOULD NOT BE SIGNED UNTIL FULLY READ AND UNDERSTOOD

The undersigned has read and voluntarily signed this release and waiver of liability and indemnity agreement, and further agrees that no oral representation, statements or inducement apart from the foregoing written agreement has been made.

 

By Checking this box you agree to the above terms and conditions.