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Table of Contents

Table of Contents Registration information . . . . . . 2, 9–15 Youth Tournaments . . . . . . . . . . .3–5 Adult Tournaments . . . . . . . . . . .6–8 Adult Mixed Doubles Tournament . . . . . 8

courses Rockford Park District courses

Sign up today for Rockford Park District golf tournaments held at these quality courses.

Aldeen Golf Club, 1902 Reid Farm Rd., Rockford (815-282-GOLF) Elliot Golf Course, 888 S. Lyford Rd., Cherry Valley (815-332-5130) Ingersoll Golf Course, 101 Daisyfield Rd., Rockford (815-987-8834) Sandy Hollow Golf Course, 2670 Sandy Hollow Rd., Rockford (815-987-8836) Sinnissippi Golf Course, inside Sinnissippi Park, 2004 Arlington Av., Rockford (815-987-8838)

Other area courses

Atwood Homestead Golf Course, 8990 Old River Rd., Rockford (815-623-2411) The Ledges Golf Course, 7111 McCurry Rd., Roscoe (815-389-0979) Macktown Golf Course, 2221 Freeport Rd., Rockton (815-624-7410) The Mauh-Nah-Tee-See Club, 5151 Guilford Rd., Rockford (815-399-0711)

Thanks to our

to register

Online

rockfordparkdistrict.org » click on My RPD

Mail-in

Rockford Park District Customer Service 401 S Main St STE 109 Rockford, IL 61101-1321

Fax

(credit card payments only) 815-987-8877

In Person

Tournament Sponsors

at Aldeen Golf Club • Aug 12, 2013 proceeds benefit Rockford Park District youth golf programs

Entry fee of $100 per golfer includes green fees and car, complimentary tee gift, lunch, and light fare following the event

2

4 ways

Rockford Women’s Golf Association

For more information, call 815-987-1602

Conny Sjostrom, Sr and Irene Sjostrom Youth Golf Scholarship

Aldeen Golf Club regulations require players to wear a collared shirt; no metal cleats allowed. If golf is canceled due to inclement weather, golf certificates will be issued. Lunch held rain or shine!

CUSTOMER SERVICE SE HABLA ESPAÑOL

Customer Service Rockford Park District, WNC 401 S Main St, Rockford Mon–Fri, 8:30 am–5:00 pm Customer Service Satellite Office, Carlson Ice Arena Perryville and Riverside, Loves Park Mon–Fri, 8:00 am–8:00 pm Sat, 8:00 am–12:00 pm Registration questions? Call RPD Customer Service at 815-987-8800 (TTY, 888-871-6171).

 e welcome the opportunity to W assist guests with disabilities to enjoy ALL our facilities, programs, and services. For assistance and information on accessibility, contact Customer Service at 815-987-8800 (TTY, 888-871-6171).

PHONE 815-987-8800 TTY 888-871-6171 ONLINE rockfordparkdistrict.org


tournaments

Tiger Cub Invitational

This will be an adult/child alternate shot event open to all youth golfers (ages 5–12) and their adult amateur golf partner (age 18+). Golfers should sign up for the division based on their age as of July 13, 2013, and must be residents of Winnebago or Boone County or a Rockford Park District golf permit holder. Putting and chipping contests will be held during the round. FUN, FOOD, AND PRIZES – everyone’s a winner! Lunch will be served after your round is complete. Tee times will start at 11 am; your tee time will be mailed. NOTE: Must register one adult and one child for a total of $20/team

YOUTH TOURNAMENTs

youth

» Ingersoll Learning Links AGES

Tournament DATE(S)

Entry Deadline

fee

ACTIVITY#

5–7 8–12 Adult Partner

Saturday, July 13 Saturday, July 13

Friday, July 5 at 5:00 pm Friday, July 5 at 5:00 pm

$10 $10

130204-05 130204-08

Saturday, July 13

Friday, July 5 at 5:00 pm

$10

130204-00

Michael Hebron FREE Youth Clinics Michael Hebron, PGA Master Professional, PGA Golf Professional Hall of Fame Member, and author, Smithtown Landing Country Club, Smithtown, NY will headline this clinic. Other instructors include Rockford Park District PGA staff and volunteers. Pre-registration is required and is limited to Winnebago or Boone county residents only. These clinics are designed for youth golfers ages 6-11 and 12-17, and will include instruction in chipping, putting, and practice on the driving range.

» Ingersoll Learning Links AGES

Date

Entry Deadline

Time

Fee

ACTIVITY#

6-11 12-17

Sunday, June, 2 Sunday, June, 2

Wednesday, May, 29 Wednesday, May, 29

9:00-11:00 am 12:30-2:30 pm

FREE FREE

130114-00 130114-12

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YOUTH TOURNAMENTS

youth

tournaments

Greater Rockford Boys Golf Classic

This 2-day tournament is for boys ages 5–18. USGA rules apply. There will be no preferred pairings or tee times. Golfers should sign up for the division based on their age as of July 11, 2013, and must be residents of Winnebago or Boone county or a Rockford Park District golf permit holder. Entry fee includes greens fee. 4-HOLE DIVISION (Ages 5–7): Participants play the 4-hole Ingersoll Learning Links each day. Players are allowed a caddy, however, spectators are not allowed in the fairway or within 50 feet of any golfer. 9-HOLE DIVISIONS (AGES 8–10 & 11–12): Participants play 9 holes each day. Players are allowed a caddy, however, spectators are not allowed in the fairway or within 50 feet of any golfer. 18-HOLE DIVISIONS (AGEs 13–14, 15–16, 17–18): Participants play 18 holes each day. Players are NOT allowed a caddy, and spectators are not allowed in the fairway or within 50 feet of any golfer.

» Ingersoll Golf Course and Learning Links DIVISION

Tournament DATE(S)

Entry Deadline

fee

ACTIVITY#

4-Hole 9-Hole 18-Hole

Thursday, July 11 & Friday, July 12 Thursday, July 11 & Friday, July 12 Thursday, July 11 & Friday, July 12

Friday, June 28 at 5:00 pm Friday, June 28 at 5:00 pm Friday, June 28 at 5:00 pm

$6 $18 $36

130205-00 130210-00 130215-00

Greater Rockford Girls Golf Classic

This tournament for girls ages 5–18. When choosing the appropriate age group, please use the age the participant will be on July 22, 2013. Participants must be a resident of Winnebago or Boone county, or a Park District permit holder. Any girl wishing to compete for the overall title should choose to play 18 holes. Her score will also count for her appropriate age group. There will be no preferred pairings or tee times. Once the pairings have been posted, they cannot be changed. Each participant must have their own clubs. Entry fee includes greens fee. With your help, we hope to make this an enjoyable day, and golf a lifetime sport for your child! 4-HOLE DIVISION (Ages 5–7, 8–10, 11 & older): Participants play the 4-hole Ingersoll Learning Links. Players are allowed a caddy, however, spectators are not allowed in the fairway or within 50 feet of any golfer. 9-HOLE DIVISIONS (AGES 8–10, 11–12, 13–14): Participants will play 9 holes. Players are allowed a caddy, however, spectators are not allowed in the fairway or within 50 feet of any golfer. 18-HOLE DIVISIONS (AGES 13–14, 15–16, 17–18): Participants play all 18 holes. Players are NOT allowed a caddy, and spectators are not allowed in the fairway or within 50 feet of any golfer. Tournament Questions? Call Marilyn Wallen at 815-629-2545

» Ingersoll Golf Course and Learning Links DIVISION

Tournament DATE(S)

Entry Deadline

fee

ACTIVITY#

4-Hole 9-Hole 18-Hole

Monday, July 22 Monday, July 22 Monday, July 22

Monday, July 15 at 5:00 pm Monday, July 15 at 5:00 pm Monday, July 15 at 5:00 pm

$3 $9 $18

130230-04 130230-09 130230-18

RAIN DATE: July 29, 2013 NOTE: This tournament is operated by the Rockford Women’s Golf Association, so Rockford Park District golf gift certificates and other forms of non-cash payment cannot be accepted. Only cash, check, credit card, or gift card payments accepted.

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PHONE 815-987-8800 TTY 888-871-6171 ONLINE rockfordparkdistrict.org


tournaments

Rockford Area Youth Tournament Series

Only 9-hole participants are allowed a caddy. No spectators allowed in the fairway or within 50 ft. of any golfer. Starting time for each tournament is 6:00 am. Tee times will be mailed 4-5 days prior to each tournament. USGA Rules will govern all play. All golf courses are NON-METAL spike facilities. Each tournament is limited to 110 18-hole golfers and 50 9-hole golfers. Tournament closes when the field is full or at the tournament deadline, whichever comes first.

This series of seven tournaments is a combined effort of the Rockford Park District and Winnebago County Forest Preserve District. Points will be awarded for each tournament, 20 points for first place, down to 2 points for 10th place. Ribbons will be awarded to the top finishers in each class, for each tournament. Season champions will be the players who score the most points in five of the seven tournaments. If you play in all seven tournaments, your five best finishes will be counted. If a tournament is rained out, the best 4 of 6 finishes will count. If two tournaments are rained out, the best 3 of 5 finishes will count, etc. The event will be divided into age divisions as follows: BOYS GIRLS Class 1 Ages 17-18 18 holes Class 6 Ages 17-18 18 holes Class 2 Ages 15-16 18 holes Class 7 Ages 15-16 18 holes Class 3 Ages 13-14 18 holes Class 8 Ages 13-14 18 holes Class 4 Ages 11-12 9 holes Class 9 Ages 11-12 9 holes Class 5 Ages 8-10 9 holes Class 10 Ages 8-10 9 holes

Tournament DATE(S) Monday, June 17

Entry Deadline Friday, June 7 at 5 pm

Location Sandy Hollow

Thursday, June 20 Monday, June 10 at 5 pm

Atwood

Monday, June 24

Ingersoll

Friday, June 14 at 5 pm

Thursday, June 27 Monday, June 17 at 5 pm

Ledges

Monday, July 1

Friday, June 21 at 5 pm

Elliot

Monday, July 8

Friday, June 28 at 5 pm

Macktown

DIVISION

Entry Fee

9-Hole 18-Hole 9-Hole 18-Hole 9-Hole 18-Hole 9-Hole 18-Hole 9-Hole 18-Hole 9-Hole 18-Hole

$9 $18 $9 $18 $9 $18 $9 $18 $9 $18 $9 $18

YOUTH TOURNAMENTs

youth

Tee Greens EntrY* Fee* Activity# $15 $25 $15 $25 $15 $25 $15 $25 $15 $25 $15 $25

$5 $10 $5 $10 $5 $10 $5 $10 $5 $10 $5 $10

130208-01 130213-01 130208-02 130213-02 130208-03 130213-03 130208-04 130213-04 130208-05 130213-05 130208-06 130213-06

*Rockford Park District and Winnebago County Forest Preserve permits will be honored for all tournaments. Those without permits must pay greens fees when checking in for the tournament. DO NOT include greens fees with entry fee when you register. There are no guarantees for tee entries. Tee entries will not be allowed if the field is full. Refund requests for individual tournaments must be made at least two days prior to the tournament date.

Rockford Area Youth Tournament Series FINALE

You must have played in or registered for at least three of the above Rockford Area Youth Tournament Series events to play in the finale at Aldeen Golf Club. The Aldeen finale is limited to 100 18-hole golfers and 40 9-hole golfers. No Tee Entries For The Aldeen Tournament.

Tournament DATE(S)

Entry Deadline

Monday, August 5

Friday, July 26 at 5 pm

Location DIVISION Aldeen

9-Hole 18-Hole

Entry Fee $12 $24

Greens Fee* Activity# $7 $15

130208-07 130213-07

*Rockford Park District and Winnebago County Forest Preserve permits will be honored for all tournaments. Those without permits must pay greens fees when checking in for the tournament. DO NOT include greens fees with entry fee when you register.

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Adult Tournaments

adult

tournaments

Greater Rockford Women’s Golf Classic

To play in this tournament, you must be a taxpayer in Winnebago, Ogle, Stephenson, or Boone county (if a full-time student under age 25, your parent/guardian must be a taxpayer in one of the above counties) or a member of the Rockford Women’s Golf Association. Students must be entering 9th grade in the fall, or older. All participants will be required to wear golf shoes with soft spikes, spikeless golf shoes, or flat-soled tennis shoes for the entire competition – NO METAL SPIKES. Tournament rules include a dress code. Appropriate golf attire must be worn at all times on the golf course and practice tees. Jeans, cutoffs, short shorts, tennis shorts/skirts, and halter/tank tops are not considered appropriate attire. Tee times for the first day of play will be listed in the Rockford Register Star the weekend before the tournament. Tee times for the match play rounds may be e-mailed upon request. Trophies and prizes will be awarded after the championship match on the last day of play. Entry fee includes greens fee. Motorized cars available for $18/rider (pay car rental at golf shop). Tournament questions? Call Betty Roska at 815-397-4099

» The Mauh-Nah-Tee-See Club AGES

TOURNAMENT DATE(S)

RAIN DATE

13+

Qualifying Round : Tues, July 23 Match Play: July 24–26

Saturday, July 27

Entry DeADLINE Fri, July 19 at 5 pm

ENTRY Fee* ACTIVITY# $80

230231-18

*An additional $10 late fee will be added to all entries received after 5:00 pm on July 19. Entries after July 19 will be limited to space available. NOTE: This tournament is operated by the Rockford Women’s Golf Association, so Rockford Park District Golf gift certificates and other forms of non-cash payment cannot be accepted. Only cash, check, credit card, or gift card payments accepted.

Aldeen Cup

Open to all male amateur golfers 18 years of age and older with a verified U.S.G.A. index of 10.7 or less. A Senior Division is available for golfers age 50 and over. A Super Senior Division is available to golfers age 60 and older. All ages are as of July 20, 2013. Tournament field will be limited to the first 120 entries. This 36-hole event will be played at scratch over two consecutive days. The Rules of Golf of the United States Golf Association and where applicable, local rules on the Aldeen Golf Club, Notice to Competitors sheet will apply. The committee reserves the right to modify the competition where necessary. Use of caddies is strongly encouraged, but not required. Carts will be permitted only for verfiable medical conditions or disabilities. Proper golf attire is required at all times for contestants, caddies, and spectators. The use of metal spikes is prohibited. Players are required to check in at least 15 minutes prior to their tee time. Check-in will be required both days, and late arrival will result in application of Rule 6-3, disqualification. Winners will be awarded trophies and gift certificates from the Aldeen Golf Shop. The Aldeen Cup champion’s name will also be engraved on the Norris A. Aldeen trophy on display at Aldeen Golf Club. For more information, contact the Aldeen Golf Shop at 815-282-4653.

» Aldeen Golf Club

6

AGES

TOURNAMENT DATE(S)

Entry DeADLINE

Res/NR Fees

ACTIVITY#

18+

Saturday, July 20 & Sunday, July 21

Friday, July 5 at 5 pm

$85/$105

230203-00

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PHONE 815-987-8800 TTY 888-871-6171 ONLINE rockfordparkdistrict.org


Adult TOURNAMENTS

adult

tournaments

Greater Rockford Men’s Golf Classic

Open to all male amateur golfers 13 years of age and older who are residents of Winnebago or Boone counties or Rockford Park District golf permit holders. Tournament field will be limited to the first 112 entries. Contestants may be required to show proof of residency when entering the tournament and/or at the registration tent on the first day of the tournament. NOTE: If you register on the Web, you must show your resident ID on the first day of play at the registration tent. The tournament format will be 72 holes of stroke play, to be played on consecutive weekends as described in schedule of play. Number of holes played may be reduced due to weather conditions. At the completion of the first weekend, the field will be cut from 112 to the low 78 golfers and ties. Motorized cars will be allowed on a first come, first served basis. Contestants will be paired on the basis of average scores as given on the registration. Players will be assigned new pairings after completion of the first weekend. Championship Flight contestants may receive new pairings for the final round. THERE WILL BE NO PREFERRED PAIRINGS OR TEE TIMES. After the completion of the first weekend, contestants will be placed in flights according to their first weekend total. There will be three flights: Championship, “A” Flight, and “B” Flight. In addition to the flights, contestants ages 55 and older making the cut will also be eligible for the “Masters” division. The committee reserves the right to modify tournament format. U.S.G.A. rules apply. Additional rules will be mailed with pairing list. Caddies will be allowed. Players and caddies are required to wear shirts and acceptable footwear at all times. Players are required to check in at the registration tent at least 15 minutes before their scheduled tee time. Check-in is required for each day of participation. Penalty for late arrival is disqualification. Winners will be awarded trophies and gift certificates. The traveling trophy is to be retained for one year by the overall tournament champion.

» Elliot, Sandy Hollow, Ingersoll, and Aldeen AGES

TOURNAMENT DATE(S)

Entry DeADLINE

13+

Round 1: Sat, July 27, Elliot Round 2: Sun, July 28, Sandy Hollow Round 3: Sat, Aug 3, Ingersoll Round 4: Sun, Aug 4, Aldeen

Wed, July 3 at 5 pm (Late entries accepted until July 12 at 5 pm)

Res/NR Entry Fee*

Res/NR Late ENTRY*

Res/NR Tee ENTRY*

ACTIVITY#

$100/$120

$110/$130

$120/$140

230220-00

* Fee discounted for Rockford Park District residents; non-residents must reside in Winnebago or Boone counties, or be a Rockford Park Distrcit golf permit holder. An additional $10 late fee will be added to all entries received after 5:00 pm on July 3. Late entries will be accepted until 5:00 pm on July 12. Tee entries will be accepted on July 27 at 5:30 am, as space allows.

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Adult Tournaments

adult

tournaments

Greater Rockford Mixed Doubles Golf Classic

Open to all amateur golfers ages 16 and older, who are residents of Winnebago or Boone county (proof of residency required) or Park District permit holders. The tournament will be a 9-hole Chapman system of alternate shots. Teams will consist of one female and one male golfer. Both will tee off. The team will alternate the second shot, then they must choose the ball they will play until the ball is holed out. Scratch and handicap prizes will be awarded. Entry is limited to the first 90 teams. No guarantees for preferred tee times or pairings. Register at Customer Service locations only.

» Sinnissippi Golf Course AGES

TOURNAMENT DATE(S)

16+

Saturday, Aug 17 Saturday, Sept14 Friday, Aug 2 at 5 pm

RAIN DATE

Entry DeADLINE

Fees

ACTIVITY#

(see below)

230222-00

ENTRY FEE: $55 for two Rockford Park District residents $65 for one Rockford Park District resident and one Winnebago or Boone county resident living outside the Rockford Park District $75 for two Winnebago or Boone county residents or Rockford Park District golf permit holders living outside the Rockford Park District. MOTORIZED CAR FEE: $18 per team

Greater Rockford Senior Golf Classic

Open to all amateur golfers ages 60 and older who are residents of Winnebago, Boone, Stephenson, Ogle, or Rock counties, or are Rockford Park District golf permit holders. The tournament will be divided into an 18hole event (two 9-hole rounds) and a 36-hole event (two 18-hole rounds). Divisions will be flighted after the first round. Contestants will be paired on the basis of average score as provided on the entry form. Contestants may request pairings, but there are no guarantees for preferred pairings or tee times. The divisions are: Men’s Women’s 36-Hole Division (18 holes each day) 36-Hole Division (18 holes each day) 18-Hole Division (9 holes each day) 18-Hole Division (9 holes each day) Each division must have four or more golfers, or the division will be cancelled (golfers may opt to play in another division). The tournament will be limited to the first 120 36-hole division entries and 60 18-hole division entries; no exceptions. Two-day motorized car rentals available. Cars will be shared when possible. No more than two motorized cars in a foursome. A championship trophy will be awarded during the awards banquet on Wednesday, August 28, 6:30 pm, to the overall winners of the 36-hole divisions. Each division winner and runner-up will receive a trophy. The top finishers in each division will receive gift certificates. Additional information on the awards banquet will be sent with the pairings (additional banquet guests $25 each).

» Ingersoll Golf Course AGES DIVISION 60+

18-Hole

60+

36-Hole

TOURNAMENT DATE(S)

Entry DeADLINE

Mon, Aug 26 & Tues, Aug 27 Mon, Aug 26 & Tues, Aug 27

Monday, Aug 5 at 5 pm Monday, Aug 5 at 5 pm

Res/NR FEE*

Motorized Car Fee

ACTIVITY#

$25/$30

$18/rider

230262-09

$35/$40

$30/rider

230262-18

* Fee discounted for Rockford Park District residents; non-residents must reside in Winnebago, Boone, Stephenson, Ogle, or Rock counities, or be a Rockford Park Distrcit golf permit holder.

8

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PHONE 815-987-8800 TTY 888-871-6171 ONLINE rockfordparkdistrict.org


GOLF TOURNAMENT REGISTRATION FORM HEAD OF HOUSEHOLD (Mixed Doubles - Please use form on pg 11) Last name First

Household ID# __________________________

Home phone

Cell phone

Work phone

How did you find out about our program(s)?

current customer

e-newsletter/social media

friend/relative

RPD program guide

newspaper

radio

TV

web site

PARTICIPANT INFORMATION MEDICATION NEEDED?*

NAME

Yes

No

Yes

No

Yes

No

Yes

No

Yes

No

Yes

No

Yes

No

Yes

No

Yes

No

Yes

No

Yes

No

Yes

No

ACTIVITY#

DIVISION (if applicable, please circle)

TOURAMENT TITLE

$

$

Yes! I would like to make a donation to the RPD Fee Assistance program to aid kids who need financial help to participate in RPD programs. Avg 18-hole score

Park District permit # (if applicable)

FEE

Avg 9-hole score

WOMEN’S CLASSIC Please also provide the following information: Is your league/club a member of the RWGA?

Yes Will you need a motorized car? c Yes c No

No

Avg 4-hole score

League/Club_____________________

SENIOR CLASSIC P lease also provide the following information: Will you need a motorized car? c Yes c No If yes, add payment to entry fee: $30/rider for 36 holes (18 holes/day); $18/rider for 18 holes (9 holes/day)

Please pair me with: _________________________________________

________________________________________________

_________________________________________

________________________________________________

PLEASE READ THE WAIVER & CONDITIONS FOUND ON THE BACK OF THIS FORM. THIS FORM IS NOT CONSIDERED COMPLETE UNTIL ALL NECESSARY INFORMATION HAS BEEN PROVIDED. WAIVER & RELEASE I have read and agree to all the terms and conditions as stated on the back of this form. Participant’s name (PLEASE PRINT) ____________________________________________________________________________________________ Parent/guardian or adult participant signature__________________________________________________________ Date________________________ PARTICIPATION WILL BE DENIED if the signature of adult participant or parent/guardian and date are not on this waiver. PAYMENT INFORMATION Credit card #

3-digit cvv/cvc code (back of card)

Exp date

Total of all fees $

Signature (Authorization for credit card use)

CUSTOMER SERVICE 815-987-8800 (TTY, 888-871-6171)

TOURNAMENT REGISTRATION FORM

9


WAIVER & RELEASE | PLEASE READ CAREFULLY | DON’T FORGET TO SIGN THE FRONT SIDE OF THIS FORM IMPORTANT INFORMATION The Rockford Park District is committed to conducting its recreation programs and activities in a safe manner and holds the safety of participants in high regard. The Rockford Park District continually strives to reduce such risks and insists that all participants follow safety rules and instructions that are designed to protect the participants’ safety. However, participants and parents/ guardians of minors registering for this program must recognize that there is an inherent risk of injury when choosing to participate in recreational programs/ activities. You are solely responsible for determining if you or your minor child/ward are physically fit and/ or adequately skilled for the activities contemplated by this agreement. It is always advisable, especially if the participant is pregnant, disabled in any way or recently suffered an illness, injury or impairment, to consult a physician before undertaking any physical activity. WARNING OF RISK Golfing is an activity intended to challenge and engage the physical, mental and emotional resources of each participant. However, despite careful and proper preparation, instruction, medical advice, conditioning and equipment, there is still a risk of serious injury. Understandably, not all hazards and dangers can be foreseen. Risks attendant to golfing include poor conditioning or technique, being struck by a golf ball or club, being struck by lightning, slipping on wet surfaces, slips and falls associated with the choice of spikes, accidents with golf carts, inconsiderate play, horseplay, defects in course design, tripping over sprinkler heads, and ruts/holes/depressions in the grass. In this regard, it must be recognized that it is impossible for the Rockford Park District to guarantee absolute safety. You should

always stand away from and behind a player making a shot and be aware of the flight patterns of balls being hit by other players when you are around the greens and alongside the fairways. You should watch where you are walking (i.e., uneven terrain, sprinkler heads, surface imperfections, etc.). When playing a shot from a wrong fairway, ensure that the players playing that fairway are aware of your presence. During a thunderstorm, do not ride in golf carts or stay outdoors; seek shelter in buildings, vehicles, or other locations that offer protection (avoid open fields, water areas, wire fences, overhead wires, isolated trees, and hilltops). Drive carefully and slowly in golf carts, they are not toys. WAIVER AND RELEASE OF ALL CLAIMS AND ASSUMPTION OF RISK Please read this form carefully and be aware that in signing up and participating in this program/activity, you will be expressly assuming the risk and legal liability and waiving and releasing all claims for injuries, damages or loss which you or your minor child/ward might sustain as a result of participating in any and all activities connected with and associated with this program/activity (including transportation services and vehicle operations, when provided). I recognize and acknowledge that there are certain risks of physical injury to participants in this program/activity, and I voluntarily agree to assume the full risk of any and all injuries, damages or loss, regardless of severity, that my minor child/ward or I may sustain as a result of said participation. I further agree to waive and relinquish all claims I or my minor child/ward may have (or accrue to me or my child/ward) as a result of participating in this program/activity against the Rockford Park District, including its officials, agents, volunteers and employees.

PHOTO/VIDEO AUTHORIZATION, CONSENT AND RELEASE OF ALL CLAIMS I hereby authorize and give my consent to the District to photograph/video me and my minor child/ward, and without limitation, to use such photographs/video in connection with promoting/advertising the services, programs, and facilities of Rockford Park District without consideration of any kind. Such productions may be copied, copyrighted, edited, and distributed by the District in the manner described above. I understand that my and my minor child’s/ward’s name, likeness, or voice may be used in the manner described above, and grant the Rockford Park District the right to use and reuse, in any manner at all, the video, motion picture, audio recording, web page, social media pages, or still photograph productions, and broadcasts as described above. I hereby waive any and all rights that my minor ward/child and I may have to examine or approve the finished product or products that contain the photograph/video of me or my minor ward/child and/or the advertising copy or printed matter that may be used in connection therewith or the use to which it may be applied. I hereby forever release and discharge the Rockford Park District from any and all claims, actions and demands arising out of or in connection with the use of said video, motion picture, audio recording, web page, social media page, or still photograph, including, without limitation, any and all claims for invasion of privacy and libel. This release shall inure to the benefits of the assigns, licenses and legal representatives of the Rockford Park District, as well as the party(ies) for whom the Rockford Park District took the video, motion picture, audio recording, web page, social media page, or still photograph.

Four convenient ways to register

Register early!

Rockford Park District Customer Service 401 S Main St STE 109 • Rockford, IL 61101-1321 FAX (credit card payments only) • 815-987-8877

Payment options

ONLINE • rockfordparkdistrict.org MAIL-IN

IN PERSON

Customer Service • Rockford Park District, WNC • 401 S Main St, Rockford Mon–Fri, 8:30 am–5:00 pm Customer Service Satellite Office • Carlson Ice Arena Perryville and Riverside, Loves Park Mon–Fri, 8:00 am–8:00 pm • Sat, 8:00 am–12:00 pm Registration questions? Call RPD Customer Service at 815-987-8800 (TTY, 888-871-6171).

Tournaments with with low enrollment may be cancelled. Registration ends one week prior to the start date of any program unless otherwise noted. Payment is required at the time of registration. We accept cash, local personal checks, credit cards ( American Express, Visa, MasterCard, and Discover Card only) and debit cards on which the VISA or MasterCard logo appears. Please make checks payable to ROCKFORD PARK DISTRICT.  e welcome the opportunity to assist guests with disabilities to W enjoy ALL our facilities, programs, and services. For assistance and information on accessibility, contact Customer Service at 815-987-8800 (TTY, 888-871-6171).

PLEASE NOTE: I F ANY OF YOUR HOUSEHOLD INFORMATION HAS CHANGED, IT IS YOUR RESPONSIBLITY TO NOTIFY CUSTOMER SERVICE, OR LOG IN ONLINE TO UPDATE YOUR PROFILE • www.rockfordparkdistrict.org

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CUSTOMER SERVICE 815-987-8800 (TTY, 888-871-6171)

TOURNAMENT REGISTRATION FORM


GOLF TOURNAMENT REGISTRATION FORM Mixed Doubles Registration PARTICIPANT INFORMATION FEMALE GOLFER: Last Name

First

Avg 9-hole Score

Parent/Guardian Name (if applicable) Home Phone

Work Phone

County of Residence c Boone

c Winnebago

Yes

No If yes, please request the Permission to Administer Medication Form.

First

Avg 9-hole Score

Work Phone

County of Residence c Boone

c Winnebago

HH ID#

Middle

Parent/Guardian Name (if applicable) Home Phone

Cell Phone

If not a resident of Boone or Winnebago counties, enter Park District permit #

Will participant(s) need to take medication during program hours? MALE GOLFER: Last Name

HH ID#

Middle

Cell Phone

If not a resident of Boone or Winnebago counties, enter Park District permit #

Will participant(s) need to take medication during program hours?

Yes

No If yes, please request the Permission to Administer Medication Form.

Yes! I would like to make a donation to the RPD Fee Assistance program to aid kids who need financial help to participate in RPD programs.

$_________

PROGRAM INFORMATION c Mixed Doubles Classic (ID# 230222-00) FEE: $ 55 for two Rockford Park District residents; $65 for one Rockford Park District resident and one Winnebago or Boone county resident living outside the Rockford Park District; $75 for two Winnebago or Boone county residents or Rockford Park District golf permit holders living outside the Rockford Park District. ADULT MIXED DOUBLES Will you need a motorized car? c YES (add $18 to entry fee)

c NO

Please pair us with: ________________________________________

_______________________________________________

_________________________________________

______________________________________________

PLEASE READ THE WAIVER & CONDITIONS FOUND ON THE BACK OF THIS FORM. THIS FORM IS NOT CONSIDERED COMPLETE UNTIL ALL NECESSARY INFORMATION HAS BEEN PROVIDED. WAIVER & RELEASE I have read and agree to all the terms and conditions as stated on the back of this form. Participant’s name (PLEASE PRINT) ___________________________________________________________________________________________ Parent/guardian or adult participant signature ___________________________________________________ Date _______________________ PARTICIPATION WILL BE DENIED if the signature of adult participant or parent/guardian and date are not on this waiver. PAYMENT INFORMATION Credit card #

Three digit CVV/CVC code

Exp date

Total of all fees $

Signature (Authorization for credit card use)

CUSTOMER SERVICE 815-987-8800 (TTY, 888-871-6171)

TOURNAMENT REGISTRATION FORM

11


WAIVER & RELEASE | PLEASE READ CAREFULLY | DON’T FORGET TO SIGN THE FRONT SIDE OF THIS FORM IMPORTANT INFORMATION The Rockford Park District is committed to conducting its recreation programs and activities in a safe manner and holds the safety of participants in high regard. The Rockford Park District continually strives to reduce such risks and insists that all participants follow safety rules and instructions that are designed to protect the participants’ safety. However, participants and parents/ guardians of minors registering for this program must recognize that there is an inherent risk of injury when choosing to participate in recreational programs/ activities. You are solely responsible for determining if you or your minor child/ward are physically fit and/ or adequately skilled for the activities contemplated by this agreement. It is always advisable, especially if the participant is pregnant, disabled in any way or recently suffered an illness, injury or impairment, to consult a physician before undertaking any physical activity. WARNING OF RISK Golfing is an activity intended to challenge and engage the physical, mental and emotional resources of each participant. However, despite careful and proper preparation, instruction, medical advice, conditioning and equipment, there is still a risk of serious injury. Understandably, not all hazards and dangers can be foreseen. Risks attendant to golfing include poor conditioning or technique, being struck by a golf ball or club, being struck by lightning, slipping on wet surfaces, slips and falls associated with the choice of spikes, accidents with golf carts, inconsiderate play, horseplay, defects in course design, tripping over sprinkler heads, and ruts/holes/depressions in the grass. In this regard, it must be recognized that it is impossible for the Rockford Park District to guarantee absolute safety. You should

always stand away from and behind a player making a shot and be aware of the flight patterns of balls being hit by other players when you are around the greens and alongside the fairways. You should watch where you are walking (i.e., uneven terrain, sprinkler heads, surface imperfections, etc.). When playing a shot from a wrong fairway, ensure that the players playing that fairway are aware of your presence. During a thunderstorm, do not ride in golf carts or stay outdoors; seek shelter in buildings, vehicles, or other locations that offer protection (avoid open fields, water areas, wire fences, overhead wires, isolated trees, and hilltops). Drive carefully and slowly in golf carts, they are not toys. WAIVER AND RELEASE OF ALL CLAIMS AND ASSUMPTION OF RISK Please read this form carefully and be aware that in signing up and participating in this program/activity, you will be expressly assuming the risk and legal liability and waiving and releasing all claims for injuries, damages or loss which you or your minor child/ward might sustain as a result of participating in any and all activities connected with and associated with this program/activity (including transportation services and vehicle operations, when provided). I recognize and acknowledge that there are certain risks of physical injury to participants in this program/activity, and I voluntarily agree to assume the full risk of any and all injuries, damages or loss, regardless of severity, that my minor child/ward or I may sustain as a result of said participation. I further agree to waive and relinquish all claims I or my minor child/ward may have (or accrue to me or my child/ward) as a result of participating in this program/activity against the Rockford Park District, including its officials, agents, volunteers and employees.

PHOTO/VIDEO AUTHORIZATION, CONSENT AND RELEASE OF ALL CLAIMS I hereby authorize and give my consent to the District to photograph/video me and my minor child/ward, and without limitation, to use such photographs/video in connection with promoting/advertising the services, programs, and facilities of Rockford Park District without consideration of any kind. Such productions may be copied, copyrighted, edited, and distributed by the District in the manner described above. I understand that my and my minor child’s/ward’s name, likeness, or voice may be used in the manner described above, and grant the Rockford Park District the right to use and reuse, in any manner at all, the video, motion picture, audio recording, web page, social media pages, or still photograph productions, and broadcasts as described above. I hereby waive any and all rights that my minor ward/child and I may have to examine or approve the finished product or products that contain the photograph/video of me or my minor ward/child and/or the advertising copy or printed matter that may be used in connection therewith or the use to which it may be applied. I hereby forever release and discharge the Rockford Park District from any and all claims, actions and demands arising out of or in connection with the use of said video, motion picture, audio recording, web page, social media page, or still photograph, including, without limitation, any and all claims for invasion of privacy and libel. This release shall inure to the benefits of the assigns, licenses and legal representatives of the Rockford Park District, as well as the party(ies) for whom the Rockford Park District took the video, motion picture, audio recording, web page, social media page, or still photograph.

Four convenient ways to register

Register early!

Rockford Park District Customer Service 401 S Main St STE 109 • Rockford, IL 61101-1321 FAX (credit card payments only) • 815-987-8877

Payment options

ONLINE • rockfordparkdistrict.org MAIL-IN

IN PERSON

Customer Service • Rockford Park District, WNC • 401 S Main St, Rockford Mon–Fri, 8:30 am–5:00 pm Customer Service Satellite Office • Carlson Ice Arena Perryville and Riverside, in Loves Park Mon–Fri, 8:00 am–8:00 pm • Sat, 8:00 am–12:00 pm Registration questions? Call RPD Customer Service at 815-987-8800 (TTY, 888-871-6171).

Tournaments with with low enrollment may be cancelled. Registration ends one week prior to the start date of any program unless otherwise noted. Payment is required at the time of registration. We accept cash, local personal checks, credit cards ( American Express, Visa, MasterCard, and Discover Card only) and debit cards on which the VISA or MasterCard logo appears. Please make checks payable to ROCKFORD PARK DISTRICT.  e welcome the opportunity to assist guests with disabilities to W enjoy ALL our facilities, programs, and services. For assistance and information on accessibility, contact Customer Service at 815-987-8800 (TTY, 888-871-6171).

PLEASE NOTE: I F ANY OF YOUR HOUSEHOLD INFORMATION HAS CHANGED, IT IS YOUR RESPONSIBLITY TO NOTIFY CUSTOMER SERVICE, OR LOG IN ONLINE TO UPDATE YOUR PROFILE • www.rockfordparkdistrict.org

12

CUSTOMER SERVICE 815-987-8800 (TTY, 888-871-6171)

TOURNAMENT REGISTRATION FORM


HOUSEHOLD INFO FORM HH ID# / Household ID# ____________________

FOR NEW CUSTOMERS ONLY Complete this form only if you have never registered for a Rockford Park District activity or purchased a season pass.

PLEASE NOTE TO REGISTER FOR PROGRAMS YOU WILL NEED TO FILL OUT THE PROGRAM REGISTRATION FORM, AVAILABLE AT ANY CUSTOMER SERVICE LOCATION, OR REGISTER ONLINE AT rockfordparkdistrict.org » click My RPD.

HEAD OF HOUSEHOLD Last name

First

Address

City

State Zip

Home phone

Work phone

Cell phone

Middle

E-mail address (optional)

Is it okay for us to contact you by e-mail about the programs you have registered for? Yes No Are you interested in receiving information via e-mail with special Rockford Park District promotions, upcoming events, registration, and announcements? Male

Female

Birth date /

Yes

No

/

Does this person have a disability or medical condition that may require assistance or accommodation? (i.e., diabetes, seizures, mental illness, conduct/behavior disorder, physical disability, developmental delay) Yes No Explain: ___________________________________________________________________ Does this person have allergies requiring medication to be dispensed during the program(s) he/she will be registering for (i.e., EpiPen, Benadryl, etc.)? Yes No Explain: ___________________________________________________________________ RACE/ETHNICITY (optional; select all that apply) American Indian/Alaskan Native Asian/Pacific Islander

Black

White

Hispanic (any race)

Other (please list)

SECONDARY HEAD OF HOUSEHOLD Please fill in phone numbers if different than those listed above. Last name

First

Home phone

Work phone

Male

Female

Birth date /

Middle Cell phone

/

Does this person have a disability or medical condition that may require assistance or accommodation? (i.e., diabetes, seizures, mental illness, conduct/behavior disorder, physical disability, developmental delay) Yes No Explain: __________________________________________________________________ Does this person have allergies requiring medication to be dispensed during the program(s) he/she will be registering for (i.e., EpiPen, Benadryl, etc.)? Yes No Explain: ____________________________________________________________________________________________ RACE/ETHNICITY (optional; select all that apply) American Indian/Alaskan Native Asian/Pacific Islander

Black

White

Hispanic (any race) Other (please list)

EMERGENCY INFORMATION Please list any adult (age 18+) whom we should contact in case the parent/guardian cannot be reached in the event of any emergency. Contact #1 (first, last name) Relationship Home phone

Work phone

Cell phone

Contact #2 (first, last name) Relationship Home phone

Work phone

Cell phone

PLEASE CONTINUE ON BACK SIDE • THIS FORM IS NOT CONSIDERED COMPLETE UNTIL ALL NECESSARY INFORMATION HAS BEEN PROVIDED CUSTOMER SERVICE 815-987-8800 ( T TY, 888-871-6171)

HOUSEHOLD INFO FORM

13


HOUSEHOLD INFO FORM HOUSEHOLD MEMBERS MEMBER #3 Male

Last name

Female

Birth date

First

/

Middle

/

Does this person have a disability or medical condition that may require assistance or accommodation? (i.e., diabetes, seizures, mental illness, conduct/behavior disorder, physical disability, developmental delay) Yes No Explain__________________________________________________________________________ Does this person have allergies requiring medication to be dispensed during the program(s) he/she will be registering for (i.e., EpiPen, Benadryl, etc.)? Yes No Explain___________________________________________________________________________________________________ RACE/ETHNICITY (optional; select all that apply) American Indian/Alaskan Native Asian/Pacific Islander MEMBER #4 Male

Black

Last name

Female

Birth date

White

Hispanic (any race)

First

/

Other (please list)_________________ Middle

/

Does this person have a disability or medical condition that may require assistance or accommodation? (i.e., diabetes, seizures, mental illness, conduct/behavior disorder, physical disability, developmental delay) Yes No Explain__________________________________________________________________________ Does this person have allergies requiring medication to be dispensed during the program(s) he/she will be registering for (i.e., EpiPen, Benadryl, etc.)? Yes No Explain___________________________________________________________________________________________________ RACE/ETHNICITY (optional; select all that apply) American Indian/Alaskan Native Asian/Pacific Islander MEMBER #5 Male

Black

Last name

Female

Birth date

White

Hispanic (any race)

First

/

Other (please list)_________________ Middle

/

Does this person have a disability or medical condition that may require assistance or accommodation? (i.e., diabetes, seizures, mental illness, conduct/behavior disorder, physical disability, developmental delay) Yes No Explain__________________________________________________________________________ Does this person have allergies requiring medication to be dispensed during the program(s) he/she will be registering for (i.e., EpiPen, Benadryl, etc.)? Yes No Explain___________________________________________________________________________________________________ RACE/ETHNICITY (optional; select all that apply) American Indian/Alaskan Native Asian/Pacific Islander MEMBER #6 Male

Black

Last name

Female

Birth date

White

Hispanic (any race)

First

/

Other (please list)_________________ Middle

/

Does this person have a disability or medical condition that may require assistance or accommodation? (i.e., diabetes, seizures, mental illness, conduct/behavior disorder, physical disability, developmental delay) Yes No Explain__________________________________________________________________________ Does this person have allergies requiring medication to be dispensed during the program(s) he/she will be registering for (i.e., EpiPen, Benadryl, etc.)? Yes No Explain___________________________________________________________________________________________________ RACE/ETHNICITY (optional; select all that apply) American Indian/Alaskan Native Asian/Pacific Islander

Black

White

Hispanic (any race)

Other (please list)_________________

PLEASE NOTE: I F ANY OF YOUR HOUSEHOLD INFORMATION HAS CHANGED, IT IS YOUR RESPONSIBILITY TO NOTIFY CUSTOMER SERVICE, OR LOG IN ONLINE TO UPDATE YOUR PROFILE • rockfordparkdistrict.org

14

CUSTOMER SERVICE 815-987-8800 ( T TY, 888-871-6171)

HOUSEHOLD INFO FORM


registration How do I know if I’m registered?

If you registered online, you will receive e-mail confirmation as soon as you have been registered in the program. If you submitted a paper registration form, you will receive a confirmation receipt through the mail listing all the programs for your family, and whether they have been enrolled in the class or placed on the waiting list. The confirmation receipt does not guarantee enrollment if the class does not fill and is cancelled. In the event your program is cancelled, you will be notified and your program fee refunded.

Waiting list policy

Some programs are very popular and fill quickly. You may opt to register for a filled program and be placed on the waiting list. To be placed on a waiting list, the program registration process must be fully completed, including payment. Your position on the waiting list is based upon when the registration is processed by the District. If the District cannot accommodate your enrollment by the second meeting of the class, your registration fee will be refunded in full. All waiting lists have a limited number of spots, so it is possible that the waiting list may already be filled at the time you attempt to register.

How do I know if I’m a resident?

Rockford Park District programs are open to both residents and non-residents of the Rockford Park District. People who are residents are paying property taxes that support the Rockford Park District, and they receive a discount on most Rockford Park District services. To determine if you are a Rockford Park District resident, you can review your personal property tax assessment to see if you are assessed by the Rockford Park District, or you can view a copy of the tax bill for your address at wingis.org. You can also call our office at 815-987-8800 during business hours to have us look up your address.

May I register for a friend?

In order to register for a friend, you must bring a completed registration form on which the Waiver and Release of All Claims and Assumption of Risk has been signed by an adult who is legally responsible for the participant.

CONNECT WITH US!

faqs Age policy

Unless otherwise noted, recreation programs require participants to reach the minimum age by Jan 1, and not reach the maximum age before the conclusion of the program. Lesson programs require that participants be within the age limits of the class by the first day of the program.

Transfer policy

Transfers are allowed up until the beginning of the first class. Transfers after a program has started must be requested through the manager of the specific program. If the transfer is to a higher priced program, the additional fee must be paid prior to the transfer. If the transfer is to a lower priced program, a credit will be issued to the household.

What is the cancellation and refund policy?

Full refunds will be granted for any registration cancelled by the participant two weeks prior to the first day of the program. If the program you’ve registered for is cancelled, a full refund will be issued. If you feel that the program you or your child participated in did not deliver the service that it was supposed to, you are entitled to a Quality Assurance refund. All we ask is that you speak with the program manager to help them understand your dissatisfaction. Partial refunds may be issued for programs that you are unable to complete due to illness or injury (it is your responsibility to notify the District of your situation before the program ends) or that the District has to cancel due to inclement weather or conditions. Some programs reserve the right to issue promotional day passes or schedule make-up classes in lieu of cash refunds for weather-related cancellations. No refunds will be issued to participants who withdraw from a program less than two weeks prior to the first day of the program. These regulations apply to recreational and instructional programs throughout the Park District. They do not apply to daily admissions, memberships, permits, leagues and rentals. These services have specific policies as part of the information provided to the participant at the point of registration.

Refunds will be issued in the form of a credit to your household account. You may redeem your credit towards any future Park District registrations for any member of your household. If your household credit is more than $10.00, you may request a refund by calling Customer Service. Refunds will be applied to any outstanding balance owed by your household for programs, activities, memberships, leagues, or rentals. If there is no outstanding balance on your account, the refund will be issued in the form of a check or applied to your credit card, based upon the method of payment used at the time of registration. Allow up to two weeks to receive your check or for the credit to be posted.

Recreation Satisfaction Guaranteed!

Our goal is to provide our customers and citizens with recreational programs, events, and activities of the highest quality. When a customer is not satisfied, we sincerely request their comments, suggestions, or ideas for improvements. If a customer is not completely satisfied with a recreational program, event, or activity the Park District directly provides, the customer may tell us and we will arrange for one of the following options of their choice: 1) Cash refund on site (when possible, limited up to $25) 2) Refund by mail (within 2-3 weeks) 3) Refund to credit card (if payment was made by credit card) 4) Refund to household account Refund applications (Quality Assurance Forms) may be filled out in writing at the facility where the program, event, or activity is delivered, or at the Customer Service Office during business hours. Season pass refunds may be pro-rated, based on the length of use during the season of operations.

Is a proud partner of

15


ROCKFORD PARK DISTRICT

prsrt std u.s. postage paid Rockford, IL Permit #4585

401 S MAIN ST • ROCKFORD IL 61101 www.rockfordparkdistrict.org Board of Commissioners Jack L. Armstrong • Douglas J. Brooks • Ian K. Linnabary • Julie Elliott • Tyler Smith Executive Director Tim Dimke

IS A PROUD PARTNER OF A PUBLICATION OF THE

2012 Tournament Winners Girls Classic Madasyn Pettersen

Senior Classic Mike Johnson and Salley Wessels

Boys Classic Danny Gorman

Mixed Doubles Classic Jason Grothman and Hui Chong Dofflemyer

Women’s Classic Cynthia Bounleutay Men’s Classic Eric Burch

Aldeen Cup Corey Konieczki

Ryder Cup Youth Skills Challenge Boys 6–8 Charlie Cox; Boys 9–11 Marcus James Smith; Boys 12–14 Harrison Engelbrecht; Boys 15–17 Kollin Elliot; Girls 6–8 Emma Raimer; Girls 9–11 Caitlin Waddell; Girls 12–14 Caitlin Schoepfer; Girls 15–17 Melissa Vansistine Rockford Area Youth Tournament Series Class 1 Michael Landerholm; Class 2 Danny Gorman; Class 3 Reid Anderson; Class 4 Joey Rock; Class 5 Adam Kuhar; Class 6 Alison Gorman; Class 7 Evelyn Behling; Class 8 Jessica Slattery; Class 9 Kristen Sayyalinh; Class 10 Katelyn Sayyalinh

2013 Rockford Golf Tournaments  

Brochure detailing the tournaments being held at the Rockford Park District golf courses in 2013.

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