2024 Inland Empire Senior Games Registration
Athlete ’ s Name - Please Print Athlete ’ s Gender: Male
Athlete Registration fee is required to participate in all individual and doubles events, with the exception of Softball. Each participant must fill out a separate application
Female
PICKLEBALL
Skill Level: 2.0 - 2.5
3.0 - 3.5
4.0 - 4.5
Doubles Partner ’ s Name:________________ Age _____ Partners Gender: Male Female Mixed Doubles Partner ’ s Name:________________ Age _____ Partners Gender: Male Female
SWIMMING
Freestyle
50Yd (11)
100Yd (8)
200Yd (1)
Backstroke 50Yd (9)
100Yd (13) 200Yd (6)
Butterfly
CORNHOLE Doubles
50Yd (5)
100Yd (7)
200Yd(10)
Singles
Breaststroke 50Yd (3)
100Yd (12)
200Yd(14)
Partner ’ s Name:__________________ Age _____ Partners Gender: Male Female
Individual Medley 100IM (4)
200IM (2)
WALK/RUN
Walk
Run
BILLIARDS
5k
10k
5k
10k
Doubles
Singles
SOFTBALL Co - Ed ($200 Per Team / No Registration Fee) Team Name:______________________________ Captain Name:____________________________
Partner ’ s Name:__________________ Age _____ Partners Gender: Male Female CORNHOLE
PAYMENT
Doubles
Singles
All events are $10 How many events are you registered for: _______
Partner ’ s Name:__________________ Age _____ Partners Gender: Male Female
Events # X $10: _______ Registration Fee: $15.00 Donations: _______
OFFICE USE ONLY
Receipt #:_____________
Total: _______
Date Received: _________
Staff Initial :_______
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