Registration “A Special Invitation To Do Good” 2017 Lake Senior Games Individual Registration Form Option #1 – Registration By Mail Click Here >> To Download Individual Registration and Release Form in PDF Format Option #2 – Online Registration 2017 Individual Registration If you would like to register online please complete the form below. After completing the online form you can make payment online. If you want to mail a check then please use Option 1 for registration by mail. Each Athlete Must Fill Out Their Own Form Name* First Last Date of Birth* Gender* Male Female Address Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Email* Phone*CellEmergency NameEmergency #Please check the box of the event(s) you wish to enter.Tennis Mens Doubles Womens Doubles Mixed Doubles Tennis Partner NameEach partner must register separately.Archery (900 rd) Barebow Compound Barebow Recurve Compound Fingers Compound Release Recurve Bowling Men Singles Womens Singles Mixed Doubles Bowling Partner NameEach partner must register separately.Cycling5K10KBoth 5K and 10KNone5K Road Race (Run) - Closed Ages 50+ Golf (scratch) 18 Holes All inclusive of Green fees, taxes, and range balls. Limited to 128 players.Pickleball Doubles Mixed Doubles Pickleball Partner NameEach partner must register separately.Powerlifting Bench Press Deadlift Total Lift Ballroom DancingSmooth (Waltz, Tango, Foxtrot)Rhythm (Cha Cha, Rumba, Swing)Smooth & RhythmNoneBallroom Dancing Partner NameEach partner must register separately.Swimming Day 1 - 100 yd Butterfly Day 1 - 200 yd Freestyle Day 1 - 50 yd Breaststroke Day 1 - 100 yd Backstroke Day 1 - 400 yd Ind Medley Day 1 - 100 yd Breaststroke Day 1 - 200 yd Backstroke Day 1 - 100 yd Ind. Medley Day 1 - 200 yd Free relay Day 2 - 50 yd Freestyle Day 2 - 200 yd Butterfly Day 2 - 50 yd Backstroke Day 2 - 200 Ind Medley Day 2 - 50 yd Butterfly Day 2 - 100 yd Freestyle Day 2 - 200 yd Breaststroke Day 2 - 500 yd Freestyle NOTE: Max Entries 6 EventsIndividual Entry FeesArchery Entry Price: $15.00 Bowling Entry Price: $20.00 Bowling 2nd event (add 1 to quantity) Price: $10.00 Quantity: 5k Road Race (Run) Price: $10.00 Cycling 5k Price: $18.00 Cycling 10k Price: $22.00 Cycling 5k & 10k Price: $30.00 Golf Entry (Includes Green fees, taxes, range balls) Price: $55.00 Tennis - First Entry Price: $15.00 Tennis - 2nd Event (add 1 to Quantity) Price: $5.00 Quantity: Pickleball - First Entry Price: $15.00 Pickleball - 2nd Event (add 1 to Quantity) Price: $5.00 Quantity: Powerlifting*Please select one of the Powerlifting options based on the number of events.One Event $15Two Events $30All 3 Events $40Swimming First Event Price: $15.00 PLEASE READ: You must indicate the number of additional swimming events in the quanity field below otherwise you will only be registered for one event. Price: $5.00 Quantity: Note: Max Entries 6 EventsBallroom Dancing (Smooth) Price: $30.00 Ballroom Dancing (Rhythm) Price: $30.00 Ballroom Dancing (Smooth & Ryhtm) Price: $50.00 TOTAL REGISTRATION FEE $0.00 Method of Payment For Online Registration*I will send payment by PayPal after submitting this form. (Please make note of the total registration fee for payment and double check all entry fees were included.)Partners In Doubles Sports - I understand that if I am participating in a sport with doubles that any partners must register and pay separately.*(This includes sports such as Pickleball, Tennis, Bowling, and Ballroom dancing).YesAcknowledgementSignature of Registered Participant*By typing my name above this shall act as my signature to indicate I have read and understood the Waiver and Release of Liability (click here to read).Date* I am ready to submit this form.*YesAfter submitting the registration form you will be automatically directed to the online payment page where you can make secure payment with credit card or PayPal. You will also receive a copy of this submission form by email. Please click the SUBMIT button below.