2023 Inland Empire Senior Games Registration
Athlete Registration fee is required to participate in all individual and doubles events, with the exception of Softball and Basketball.
Athlete ’ s Name - Please Print
Athlete ’ s gender: Male
Female
Each participant must fill out a separate application
PICKLEBALL
Skill Level: 2.0
2.5
3.0
3.5
4.0
4.5
SWIMMING
Doubles Mixed Doubles Partner ’ s Name:__________________ Age____ Partner ’ s Name:__________________ Age____
Freestyle 400m
100m
50m
Butterfly
100m
50m
TENNIS Doubles
Breaststroke 100m
Mixed Doubles Partner ’ s Name:__________________ Age____ Partner ’ s Name:__________________ Age____
50m
Backstroke 200m
100m
50m
CORNHOLE
Individual Medley 200m
Skill Level: 2.0
100m
2.5
3.0
3.5
4.0
4.5
WALK/RUN
Doubles Singles Partner ’ s Name:__________________ Age____ Partner ’ s Name:__________________ Age____ Mixed Doubles
Walk
5k
10k
Run
HORSESHOES
5k
10k
Doubles Single Partner ’ s Name:__________________ Age____ Partner ’ s Name:__________________ Age____ Mixed Doubles
BILLARDS Singles
BOWLING
PAYMENT
All events are $10 In addition $15 Registration How many events are you registered for: _______
Doubles Single Partner ’ s Name:_________________ Age____ Partner ’ s Name:_________________ Age____ Mixed Doubles
Events # X $10: _______ Registration Fee: $15.00 Donations: _______
OFFICE USE ONLY
Receipt #:_____________
Total: _______
Date Received: _________
Staff Initial :_______
Registration is Due By September 18th
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