Download a PRINTABLE .pdf Registration Form (1 page)

pages)

Registration forms will be available May 5, 2010. forms


Below is a copy of the registration form. In order to print this page, download the above registration form.
Please note that you MUST complete both the registration and entry forms.

Registration Form

Name: ____________________________________

Mail address: ______________________________

City, State, Zip: _____________________________

Phones: __________________________________

E-mail: ___________________________________

Date of Birth: ____/____/____        Age: _____  M / F

Emergency Contact:_________________________
Phone:____________________________________
Indicate home/work/cell with h/w/c

Registration Fee $25.00                            $               
Late Fee after July 10th, additional $15.00

Total Event Fees from Entry Form          $________

        I will attend Opening Ceremony       Y          N
        I will attend Closing Ceremony         Y          N

___ Guests for Opening @ $10.00 each  $________

___ Guests for Closing @ $10.00 each   $________

Donation      Thank You!             $________

Total Amount            $________
Free for 90 and over

If you didn’t participate in 2008, tell us who
recruited you: _________________________ :
Prize drawing from these names at Opening.

First 150 registrants will receive a T-shirt
Indicate size

      S              L              XL           XXL           XXXL

 

Make check or money order to:
Alaska International Senior Games or AISG
Mail to:                 PO Box 73225
                            Fairbanks, AK 99707-3225
OR Deliver to:       Big Dipper SkateRoom
                            1920 Lathrop Street

 

Athletic Waiver and Release of Liability
READ BEFORE SIGNING

In consideration of being allowed to participate in any way in the Alaska Senior Games program, related events and activities, the undersigned acknowledges, appreciates, and agrees that:

1. The risk of injury from the activities involved in these programs is significant, including the potential for permanent disability and death, and while particular rules, equipment and personal discipline may reduce this risk, the risk of serious injury to me does exist; and,
2. I KNOWINGLY AND FREELY ASSUME ALL SUCH RISKS, both known and unknown, EVEN IF ARISING FROM THE NEGLIGENCE OF THE RELEASEES or others, and assume full responsibility for my participation; and,
3. I willingly agree to comply with the stated and customary terms and conditions for participation. If I observe any unusual significant concern in my readiness for participation and/or in the program itself, I will remove myself from participation and bring such to the attention of the nearest official immediately; and
4. I, for myself and on behalf of my/our heirs, assigns, personal representatives and next of kin, HEREBY RELEASE THE Alaska International Senior Games, INC, its officers, officials, agents and/or employees, other participants, sponsoring agencies, sponsors, advertisers, and, if applicable, owners and lessors of premises used to conduct the event (“Releasees”), WITH RESPECT TO ANY AND ALL INJURY, DISABILITY, DEATH, or loss or damage to person or property incident to my involvement or participation in these programs, WHETHER ARISING FROM THE NEGLIGENCE OF THE RELEASEES OR OTHERWISE, to the fullest extent permitted by law; and
5. I, for myself and on behalf of my/our heirs, assigns, personal representatives and next of kin, HEREBY INDEMNIFY AND HOLD HARMLESS all the above Releasers from any and all liabilities incident to my involvement or participation in these programs, EVEN IF ARISING FROM THEIR NEGLIGENCE, to the fullest extent permitted by law.
6. I willingly grant permission to The Alaska International Senior Games, Inc. to use images captured during regular and special activities through video, photo and digital cameras to be used solely for the purposes of the Alaska International Senior Games promotional material and publications, and waive any rights of compensation or ownership thereto.

I HAVE READ THIS RELEASE OF LIABILITY AND ASSUMPTION OF RISK AGREEMENT, FULLY UNDERSTAND ITS TERMS, UNDERSTAND THAT I HAVE GIVEN UP SUBSTANTIAL RIGHTS BY SIGNING IT, AND SIGN IT FREELY AND VOLUNTARILY WITHOUT ANY INDUCEMENT.

Signature: _________________________    Date_____ /2009

Print name:

 

2008 Games Results | NSGA Performance Standards (pdf) | NSGA Game Rules (pdf)