Registration Form: PLEASE PRINT all information below. Name: ____________________________________________________________________________________________ (Last) (First) (Middle) Address:__________________________________________________________________________________________ (Street) (City) (State) (Zip) Phone Number: (Home) _________________________________ (Cell) ________________________________________
Email address: _____________________________________________________________________________________ Age Group: Circle One (50-54) (55-59) (60-64) (65-69) (70-74) (75-79) (80-84) (85-89) (90-94) (95+) T -Shirt Size: Medium Large X Large 2X Large 3X Large 4X Large Date of Birth: _______________________ Gender: Female Male Emergency Contact and phone number:____________________________________________________________ One shirt per registered participant. T-shirts will not be provided to spectators. Type of Registration (please select one) “From Portsmouth to Paris, Celebrating Olympic Games 2024” Monday, May 6, 2024 Billiards & Table Tennis Senior Station 3500 Clifford St. Tuesday, May 7, 2024 Track & Field at I.C Norcom High School 1801 London Blvd Opening Ceremony & Senior Information Fair Portsmouth Sportsplex 1800 Portsmouth Blvd. Wednesday, May 8, 2024 Table Games Checkers Dominoes Spades Portsmouth Sportsplex 1800 Portsmouth Blvd. Thursday, May 9, 2024 Active Games Beanbag Bocce Ball Corn Hole Pickleball Softball Hit & Throw Awards Ceremony Portsmouth Sportsplex 1800 Portsmouth Blvd.
Keep This Sheet For Your Information
2024 Portsmouth Senior Sports Days
Portsmouth Department Of Parks And Recreation
34
Years
of active play Celebrating Older Americans Month
“Power By Connection”
Robert Batcher 2024 Sports Day Keynote speaker Senior Sports Days Full Registration: $40.00
Daily Registration (choose each day you will attend)
$15.00 per day - One t-shirt per registered participant Monday Tuesday Wednesday Thursday
Spectator Only (choose each day you will attend)
$10.00 per day Monday Tuesday Wednesday Thursday
Y ou must be present in order to receive your registration package on the day of your event/events.
No Refunds After April 5, 2024.
Statement of Understanding Hold Harmless Assumption of Risk I,______________________________________, a participant in the Senior Sports Days to be held at all locations listed, beginning Monday, May 6 - Thursday, May 9, 2024 agree that I will indemnify and hold harmless the City of Portsmouth, The Department of Parks and Recreation and the Portsmouth Task Force on Aging, and their assigns from and against all loss or damage suffered by the participant at the Senior Sports Days. I thoroughly understand that I_________________________ ________, am assuming the risk for my activities during the Senior Sports Days. I hereby grant the City of Portsmouth, Department of Parks and Recreation and it’s agents permission to take or have taken still and moving pictures for the primary purpose of promoting and aiding the City of Portsmouth, Department of Parks and Recreation and Portsmouth Task Force on Aging and its work. I understand that the pictures may be revoked by me in writing to the City of Portsmouth, Department of Parks and Recreation and Portsmouth Task Force on Aging. ____________________________________________________ ________________________ (Signature) (Date) Dietary Options (please select one): Meat Option Vegan Option Senior Station 2024 copy.indd 1Senior Station 2024 copy.indd 1 3/11/24 11:27 AM3/11/24 11:27 AM
Portsmouth Department of Parks and Recreation Portsmouth T ask Force on Aging Senior Sports Day Executive Committee Virginia Senior Games will be September, 5 – 8, 2024. Information will be available at registration table.
Any Hampton Roads resident 50 and older. Complete both sides of registration form mail or drop off on or before March 31, 2024. Include all registration fees, make checks or money orders payable to Portsmouth City Treasurer. NO REFUNDS AFTER APRIL 5, 2024.
Mail or drop off registration form to
Portsmouth Department of Parks and Recreation Senior Station 3500 Clifford Street Portsmouth, V A 23704 Y ou will receive written conformation by mail which must be presented on the days of your events. Lunch will be provided May 6 - 9, 2024. Please select ONE event per time slot. If you select more than one event, the committee will select an event for you. Registration packets will be given on the day of your first event. You are the only person that can pick up your registration packet, the committee will not give your packet to anyone other than the registered participant. $40 - Full Registration includes four days of competition events, lunch and one t-shirt. $15 - Daily Registration includes daily competition events, lunch, and one t-shirt for the selected day. 9:30 am _____ Beanbag Thr 2024 Senior Sports Days Information Sheet
Informa Tion And Registra Tion Form
Organized By
Virginia
Senior Games
Eligibility
Registration
Fees
Registered
Participants
Lunch
Additional
Information
Monday, May 6, 2024
- Billiards
9 am check in Event start time 10 am Senior Station 3500 Clifford St.
- Table Tennis
9 am check in Event start time 10 am Senior Station 3500 Clifford St. Tuesday, May 7, 2024
- Track & Field
Registration opens 7:30 am (Pick up on field) Event start time 8:30 am
- I.C. Norcom Track Field
1801 London Blvd. Portsmouth, VA 23704
- Senior Information Day
9 am – 2 pm Opening Ceremony 11 am Portsmouth Sportsplex 1801 Portsmouth Blvd. Wednesday, May 8, 2024
- Indoor/Outdoor Events
Registration opens 8 am Events start 9 am
- Portsmouth Sportsplex
1801 Portsmouth Blvd. Portsmouth, V A 2370
Thursday, May 9, 2024
- Outdoor Events
Registration opens 8 am Events start 9 am Awards Ceremony 2pm From Portsmouth to Paris Olympic Games
Monday May 6, 2024 Select one event per time slot 9 am: Registration opens 10 am _____ Billiards 10 am _____ Table Tennis T uesday , May 7, 2024 Select one event per time slot 8:30 am _____ ½ Mile Walk 9 am _____ 1 Mile Walk 9:30 am _____ 50 Meter Dash 10 am _____ 100 Meter Dash 10 am _____ Discus Throw 10 am _____ Relay 4x100 meter Relay 10 am _____ Shot Put 9 am – 2 pm: Senior Information F air 11 am: Tuesday Opening Ceremony 12:30 pm – 1:30 pm: Lunch and Raffle 1:30 pm _____ Corn Hole 1:30 pm _____ Softball Hit & Throw
Please check those events you wish to enter. Individual events may be cancelled if there is insufficient registration or inclement weather. Schedule Of Events Select only one event per time period each day
X X X
X
Wednesday , May 8, 2024 Select one event per time slot 8 am: Registration opens 9 am _____ Dominoes 10 am _____ Pickle Ball 10 am _____ Spades
12:30 pm – 1:30 pm: Lunch 1:30 pm _____ Checkers 1:30 pm _____ Frisbee Throw
Thursday , May 9, 2024 Select one event per time slot 8 am: Registration opens 8:30 am _____ Bocce Ball 9:30 am _____ Beanbag Throw 9:30 am _____ Horseshoes 10 am _____ Basketball Throw 12:30 pm – 1:30 pm: Lunch 2 pm: Awards Ceremony From Portsmouth to Paris, Olympic Games
To Register
Schedule Of Events
Registration Form
X
One t-shirt per registered participant $10 - Spectator Only includes access to watch competition events and lunch. No t-shirt will be provided. Senior Station 2024 copy.indd 2Senior Station 2024 copy.indd 2 3/11/24 11:27 AM3/11/24 11:27 AM
Portsmouth Department of Parks and Recreation Portsmouth T ask Force on Aging Senior Sports Day Executive Committee Virginia Senior Games will be September, 5 – 8, 2024. Information will be available at registration table.
Any Hampton Roads resident 50 and older. Complete both sides of registration form mail or drop off on or before March 31, 2024. Include all registration fees, make checks or money orders payable to Portsmouth City Treasurer. NO REFUNDS AFTER APRIL 5, 2024.
Mail or drop off registration form to
Portsmouth Department of Parks and Recreation Senior Station 3500 Clifford Street Portsmouth, V A 23704 Y ou will receive written conformation by mail which must be presented on the days of your events. Lunch will be provided May 6 - 9, 2024. Please select ONE event per time slot. If you select more than one event, the committee will select an event for you. Registration packets will be given on the day of your first event. You are the only person that can pick up your registration packet, the committee will not give your packet to anyone other than the registered participant. $40 - Full Registration includes four days of competition events, lunch and one t-shirt. $15 - Daily Registration includes daily competition events, lunch, and one t-shirt for the selected day. 9:30 am _____ Beanbag Thr 2024 Senior Sports Days Information Sheet
Informa Tion And Registra Tion Form
Organized By
Virginia
Senior Games
Eligibility
Registration
Fees
Registered
Participants
Lunch
Additional
Information
Monday, May 6, 2024