For athletes that compete in more than one state senior games, please register using the same first name to help us serve you better.

Name:______________________________________

Address:____________________________________

City:________________State:_______Zip:_________

Telephone Number:____________________________

E-mail Address (optional):______________________

For being allowed to participate in the Mesquite Senior Games program, the undersigned participant agrees to all of the following: To inspect the facilities and equipment in use, and if unsafe, to notify the MSG supervisor and refuse to participate, He/She acknowledges that each participant will engage in activities that involve risks and accepts personal responsibility for all possible consequences including injury or death; agrees not to sue Mesquite Senior Games, its officials, representatives, sponsors and participants for death or injury or damage to property caused, or allegedly caused in whole or in part by negligence of the releasee. He/She warrants that he/she is in good health and condition and has contacted their physician to learn this fact. MSG officials or their designated medical professionals have permission to provide emergency medical treatment if needed. He/She grants the MSG and its sponsors the right to use their names and pictures and video or audio taken during the Mesquite Senior Games.