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CROSS COUNTRY 1500 Meters Wednesday 6:00 by H9ogoZc


									                     2012 Kentucky Capital Senior Games Application
                                 Hosted by United Way of Franklin County
                                              September 5-9
Name______________________ E-mail _____________________ Cell Phone/Phone_________________
Address_________________________ City_____________ Zip_______ Shirt Size _______
Age as of December 31st, 2012 _______

HORSESHOES:           Thursday 6 PM       Singles ___                                        Millville

GOLF                 Thursday 8 AM 18 Hole-Scratch ___                                       Lakeview Springs

TENNIS:               Thursday 1 PM     Singles ___ Doubles ___ Mixed Doubles ___           Juniper Hills Park

TABLE TENNIS:        Friday   9 AM      Singles ___ Doubles ___ Mixed Doubles ___         Senior Activities Center

ROAD RACE:            Friday 7 PM         5k ___                                             State Capitol

ARCHERY:              Saturday 10 AM    Barebow compound w/o sights ___ Compound Release ___
                                  Recurve w/sights ___ Compound fingers w/sights ___
                                  Barebow recurve w/o sights ____

BADMINTON:            Saturday 9 AM     Singles ___ Doubles ___ Mixed Doubles ___             Second Street Gym

RACQUET BALL:         Saturday 8AM        Singles___     Doubles ___

Graviss McDonalds
Restaurants CYCLING: Sunday 8AM 5K ____ 10K ____ 20K ____                 Time Trials        Glenns Creek Rd-
                                                                                            Harrod Concrete

BOWLING:              Sunday 1 PM      Singles ___ Doubles ___ Mixed Doubles___         Capital Bowl

TRACK & FIELD:       Sunday 3 PM 100 ___ 200 ___ 400 ___ 800 ___ 1500 ___               Western Hills High School
                    Discus ___ High Jump ___ Javelin ___ Long Jump ___
                    Shot put ___ Pole Vault ___ Triple Jump ___
                    1500 Meter Race/Walk ___ 5k Race/Walk ___ 50 ___

                                            (Age groups are five years:
                                            50-54, 55-59, 60-64, etc.)

Entry Fees:   $20 one sport except golf (additional $10), $25 covers all sports. Early deadline: Sept 1st
              $20 Bowling one competition, additional $8.25 lineage fee for additional competitions
                                  Late registration (after Sept 1st) or on site $35

                           Make check payable to: United Way of Franklin County
                Mail to: United Way of Franklin County - c/o Kentucky Capital Senior Games
                                    PO Box 1544 - Frankfort KY 40602
                Questions? Contact Frank Miklavcic at: or 502-320-2264
                                                                        Entry Fee ________
                                                   Additional bowling lineage fees ________
                                                       Additional greens fee for golf ________
                          Additional donation to United Way of Franklin County ________
                                                                              Total ________
                 Participant Waiver-Kentucky Capital Senior Games

I know that participating in the Kentucky Capital Senior Games is potentially hazardous activity, which could cause
injury or death. I will not enter and participate unless I am medically able and properly trained, and by my signature, I
certify that I am medically able to perform this event, and am in good health, and I am properly trained. I agree to
abide by any decision of an event official relative to any aspect of my participation in this event, including the right of
any official to deny or suspend my participation for any reason whatsoever. I assume all risks associated with running
in this event, including but no limited to: falls, contact with other participants, the effects of the weather, including
high heat and/or humidity, traffic and the conditions of the road, all such risks being known and appreciated by me.
Having read this waiver ad knowing these facts and inconsideration of your accepting my entry, I, for myself and
anyone entitled to act on my behalf, waive and release the United Way of Franklin County, the city of Frankfort,
Millville Community Center, First United Methodist Church, Frankfort City Schools, Lakeview Springs, Kentucky
State University , Frankfort YMCA, Capital Bowl, Franklin County Senior Activities Center and all sponsors, their
representatives and successors from all claims or liabilities of any kind arising out of my participation in this event,
even though that liability may arise out of negligence or carelessness on the part of the persons named in this waiver.

I acknowledge that I have suffered an injury or illness during said event and have been offered medical assistance
and/or transport to a medical facility for said injury. However, I have declined such medical assistance/transport to a
medical facility and have willingly elected to continue in the above event with full understanding that my conduct
may increase my risk of serious injury or death, including other unknown risks not reasonably foreseeable at this time,
and that I willingly agree to assume all risk and accept personal responsibility for my actions and any damages as a
result of such injury, including permanent disability or death, and I do hereby release, discharge and covenant to
indemnify and not to sue the organizer(s) of said event, its affiliated organizations and sponsors, employees and
associated personnel, officers, directors, agents, including the owners and lessors of premises used to conduct the
event, and I also agree to save and hold harmless and indemnify each and all parties herein referred to above from all
liability, loss, cost, claim or damage whatsoever as a result of my actions referenced herein.

I grant permission to all of the foregoing to use my photographs, motion pictures, recordings or any other record of
this event for any legitimate purpose.

Name (please print):____________________________________________________________________

Signature:____________________________________________                               Date:_____________
                                         United Way of Franklin County
                                      Kentucky Capitol Senior Games
                                                 September 5-9, 2012

        As a kickoff for the 2012 United Way Annual Campaign, the United Way of Franklin County is hosting the
2012 Kentucky Capital Senior Games September 5-9 in Frankfort. One goal of the United Way is to promote health
and wellness in the community. The Games will consist of sixteen different sports over five days for individuals 50
& over. Actually the age determining date is December 31, 2012, so an individual who is now 49 but will be 50 by
the end of the year is eligible to compete. Five year ages for each event: 50-54, 55-59, 60-64, etc. Medals to the top
three in each age group. This is an opportunity for seniors to get out and exercise, compete and have fun. This is also
a warm up for the 2012 Kentucky Senior Games to be held in Murray, October 3-October 7.

        The competitions kickoff on Wednesday, September 5 with swimming at Juniper Hills pool at 1 PM, and 1500
meter cross country run at the Archives at 6 PM. Thursday golf at Lakeview Springs with tee time shotgun starts at 8
AM, ennis at Juniper Hills at 1 PM, horseshoes at the “World Capital of Horseshoes” in Millville at 6 PM, and
volleyball at First United Methodist Church at 6 PM highlight the day’s events. Friday activities include table tennis
at the Franklin County Senior Activity Center at 9 AM, plus a 5K road race at 6:30 at Lakeview Park. Saturday
events are badminton(singles, doubles, & mixed doubles) at 9 AM at the Frankfort High Gym, archery at 10 AM and
and racquetball. The final day closes with the Graviss McDonald’s Restaurants 5K, 10K, 20K cycling races on
Glenns Creek Road at 8 AM, bowling(singles, doubles, mixed doubles) at Capital Bowl at 1 PM, 3-on-3 basketball at
Frankfort High Gym at 1 PM and track & field at Western Hills High School track at 3:00 PM and
Entry fee is $20 for one sport or $25 for more than one sport. There will be additional charges for golf and bowling.
Each competitor is guaranteed a Kentucky Capital Senior Games t-shirt.
        Updated information can be found at or call 502-875-1675 if you are
interested in volunteering or sponsoring events. For sports specific information email or call

               WED           THURS                FRI           SAT           SUN
Swimming         JUNIPER
                  1:00 PM

Cross           ARCHIVES
                 6:00 PM
Horseshoes                      MILLVILLE
                             COMMUNITY CENTER
                                   6 PM

Volleyball                       CANCELLED

Golf                          LAKEVIEW SPRINGS
                                  8:00 AM
Tennis                       JUNIPER HILLS
                                  1 PM

Table                                           SENIOR
Tennis                                          CENTER
                                                 9 AM
5K Road                                       LAKEVIEW
Race                                           PAVILION
                                                6:30 PM
Badminton                                                    SECOND
                                                           STREET GYM
                                                              9 AM

Racquetball                                                YMCA/KSU
                                                             8 AM

Archery                                                    10 AM COVE

Bowling                                                                 CAPITAL
                                                                        BOWL SAT
                                                                        1 PM

Graviss                                                                   GLENNS
                                                                        CREEK ROAD
McDonald’s                                                                 8 AM
Track &                                                                  WESTERN
                                                                         HILLS HS
Field                                                                   TRACK 3 PM

Basketball                                                              CANCELLED


Juniper Hills Pool- 800 Louisville Road
State Department of Library and Archives & Vietnam Memorial- 300 Coffeetree Road
Lakeview Springs Golf Course 112 Park Ave
Senior Activity Center    202 Medical Heights Drive
Juniper Hills Tennis Courts 800 Louisville Road
Millville Community Center 6715 McCracken Pike Versailles, Ky
First United Methodist Church 211 Washington St.
State Capitol - 700 Capitol Ave
Cove Spring Archery Complex Peaks Mill Rd
Kentucky State University 400 East Main St.
Capital Bowl 80 Anderson Road
Harrod’s Concrete 1600 Glenns Creek Rd
Western Hills High School track 300 Bondurant Drive
Second Street Gym 506 W. Second Street
Capital Plaza Hotel 405 Wilkinson Blvd
2012 Capital Senior Games Tentative Schedule
Order of Events:

Wednesday Sept 5
Swimming Juniper Hills Poll
Registration 12:00 Warmup 12:30
Start 1:00
Rolling schedule starting at 1:00 PM
200 IM (fly, back, breast, free)
100 free
100 back
100 breast
100 fly
50 free
50 back
50 breast
50 fly
200 free
200 back
200 breast
400 free

Cross Country State Library & Archives 1500 Meters 6:00 PM       Registration 5:30

Thursday Sept 6
Golf (18 Hole Scratch) Lakeview Springs Shotgun Start 8:00 AM Registration 7:30 AM
Tennis     Junipers Hills 1:00 PM Registration 12:30 Round Robin
Volleyball CANCELLED
Horseshoes Millville Community Center 6:00 PM Registration 5:30
           Round Robin 30 Shoes, Score all

Friday Sept 7
5K Race/Walk Capitol 6:30 PM Registration 5:30
Table Tennis Franklin County Senior Activities Center 9:00 AM Registration 8:30 AM
             Round Robin- Singles followed by Doubles, followed by Mixed Doubles

Saturday Sept 8
Racquetball Frankfort Downtown YMCA Round Robin Singles followed by Doubles followed by
       Mixed Doubles 8 AM Registration 7:30 AM

Badminton Frankfort High School Gymnasium Round Robin Singles followed by
          Doubles followed by Mixed Doubles 9 AM Registration 8:30 AM

Archery     10 AM Capital Driving Range Registration 9:30
          FITA-style targets. NSGA regulations

Sunday Sept 9
Cycling     Harrod Concrete 1600 Glenns Creek Rd
          5K Time Trial 8:00 AM Registration 7:30 AM
          10K Time Trial 8:45 AM Out and back
          20K Time Trial 10:00 AM Out and back twice

Bowling    1 PM Capital Bowl       Singles followed by Doubles followed by Mixed Doubles
          Registration 3:30

3 on 3 Basketball      2 PM CANCELLED
           Round Robin
Track & Field Western Hills Track 3 PM
Field Events
Open Pit
Long jump men & women followed by triple jump at 3:00
Shot put men followed by shot put women at 3:00
Discus women followed by discus men at 3:00
Pole vault men & women
High jump men & women
Javelin will follow the completion of 800.

Running Events 3:00 PM Rolling Schedule
50 Meter Dash
100 Meter Dash
1500 Meter Run
1500 Meter Racewalk
200 Meter Dash
400 Meter Dash
800 Meter Run
5000 M Racewalk to follow javelin

Tentative 2013 Kentucky Senior Games Schedule     September 4-8
Tentative 2014 Kentucky Senior Games Schedule September 3-7

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