[Ct-nfb] fishing contest
Elizabeth Rival
erival at comcast.net
Thu Apr 18 17:06:22 UTC 2013
5th Annual
2013 Connecticut SENIOR VIP Fishing Tournament
Date: Sunday, April 21, 2013
(See schedule for times)
Tournament VIP Participant and Volunteer Application
Sage Park Pond, Berlin Connecticut
Instructions: Each VIP will be allow one sighted companion for assistance
during the event. All attendees are required to complete this form. VIP
participants will be accepted on a first come, first serve basis as we are
limited to 30 participants for this event. Please complete and return this
application BEFORE Saturday, April 6, 2013.
_____VIP _____ Sighted Guide _____ Volunteer
First Name____________________ Last Name_____________________
Street_______________________________________________________
PO Box_____________________________________________________
City__________________________________State______Zip_________
Home Phone________________________Cell______________________
Email Address:_______________________________________________
Date of Birth_________________Sex ____M____F
Are you a Lion? _____YES _____ NO
If YES, which club?___________________________________________
Do you have a preferred "companion" to assist you during the event?
___ YES ___ NO
Companion's name:__________________________________________
Please specify:
____Sighted ____Totally Blind ____Partially Sighted ____Newly Blind
Do you use a wheelchair, walker or seeing eye dog? ___ YES ___ NO
Do you have special equipment or dietary needs? ___ YES ____NO
If so, please explain___________________________________________
List any medical problems and/or medications taken on a regular basis
____________________________________________________________
____________________________________________________________
Name of Emergency Contact:
_________________________________Phone:_____________________
Please return this completed application to Lion Charley Satkowski BEFORE
Saturday, April 6, 2013.
Charley Satkowski
222 Toll Gate Road
Berlin CT 06037-3610
For additional information, or if you have questions, please contact Charley
@ (860) 828-1427 or email <mailto:satkowski at sbcglobal.net>
satkowski at sbcglobal.net
SCHEDULE:
Registration and Breakfast (8:00am to 9:00am)
Fishing (9:00am to 12:00 noon)
Lunch (12:00 noon)
Directions to Sage Park:
Using 1-91 (North or South)
Take I-91 to Exit 22 North (Route 9)
Travel approximately 3 miles on Rt. 9 to Exit 22 off Rt. 9 and proceed to
end of ramp. Turn right. Proceed 50 yds. to next light and turn right onto
Worthington Ridge. Proceed straight through next light (center lane) on
Worthinton Ridge. Continue to end of Worthington Ridge (approximatley 1-1/2
miles). At light at end of Worthington Ridge take left and go north on route
15 (Berlin Turnpike). Take right at sign for Sage Park.
Using I-84 (East for West)
Take I-84 to Rte 72 Exit for New Britain.
Continue on Route 72 East through New Britain. (Route 72 becomes Route 9
South). Take exit 22 off Route 9- proceed to end of ramp. Turn right.
Proceed 50 yards to next light and turn right onto Worthington Ridge.
Proceed straight through next light (center lane) on Worthington Ridge.
Continue to end of Worthington Ridge (approximately 1-1/2 miles). At light
at end of Worthington Ridge take left and go north on route 15 (Berlin
Turnpike). Take right at sign for Sage Park.
Route 15 from Hartford:
Follow Route 15 and enter Berlin.
Pass Mickey Finns and continue for several miles.
Take left to northbound lane of Rte. 15 at third light after Mickey Finns.
(intersection of Worthington Ridge with Rte. 15). (Fire house across street
on left).
Go North on Rte. 15 for 1/4 mile and take right at sign for Sage Park.
Route 15 from New Haven:
At Meriden Rte. 91/15 intersection take Exit 17 to Berlin.
Follow Rte. 15 north into Berlin.
Pass fire station on right at light.
Continue on Rte. 15 for approximately 1/4 mile and take right at sign to
Sage Park.
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