[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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