Extremity Games

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Athletes with Disabilities Network
2845 Crooks Road.
Rochester Hills, MI 48309
Phone: 248.829.8353

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Skateboarding
Skaters will throw down their most technical tricks while representing originality and style on our street course!

Rock Climbing
Show off your skills on top rope, or drop the harness and go bouldering – we've got 35,000 sq ft of sweet climbing terrain!

Kayaking
Competitors will race against other competitors on an outdoor course, challenged by different obstacles and turns.

Wakeboarding
Make a splash stanging up or sitting down. Whatever you do, rock the wake and hit big air!

Mountain Biking
Competitors will race against other competitors on an outdoor course.

Moto-X
Riders will be challenged by a gnarly outdoor course on 80 acres of natural rolling terrain!

Martial Arts Open Forms and Sparring Exhibition

Extremity Games is organized by Athletes with Disabilities Network (ADN), a subsidiary of Easter Seals – Michigan. Established in 2009, ADN's mission is to promote a better quality of life by creating opportunities for athletes with physical disabilities.

ADN organizes Extremity Games, as well as Athletes with Disabilities Hall of Fame, which recognizes and honors men and women who have overcome physical challenges to become elite athletes and superior role models.

Extremity Games 7 Registration Form

I hereby confirm that I am considered an amateur in the sport(s) that I will be competing in during Extremity Games. I, or my guardians, also agree to sign a waiver of liability and review all rules and regulations prior to competing in the event or attending an instructional clinic. I also hereby acknowledge that by submitting this registration form that I, or my guardians, are authorizing Athletes with Disabilities Network (ADN) to publish and use my information and photos to promote ADN and/or Extremity Games.
Contact Information (*Mandatory)
First Name*:		Last Name*:
Address 1*:		Address 2:
City*:		State*:
Country:		Zip*:
Phone*:		Email*:
Gender*: Male Female
Age (at time of competition)*:
Indicate which limb loss or limb difference applies*:
Lower Extremity Amputation/Limb Loss Upper Extremity Amputation/Limb Loss Lower and Upper Extremity Amputation/Limb Loss Amputation/Limb Loss - Other Spinal Cord Injury - paraplegic Spinal Cord Injury - quadriplegic Spinal Cord Injury - Other Limb Loss/Limb Difference Other
Have you competed in the Extremity Games before?*
Yes No
Indicate your t-shirt size*:
Small Medium Large X-Large 2XL


COMPETITIONS Check the following Competitions you are registering to participate in, if any:
May 26, 2012 – Extremity Games Motocross Competition Motocross - Stand-Up Motocross - Sit-down* All Sit-down riders must be strapped in during the race. June 23, 2012 – Extremity Games Main Event Competitions*
	Skateboarding	Elite	Novice
	Wakeboarding	Elite	Novice
	Kayaking	Elite	Novice
	Speed Rock Climbing	Elite	Novice
	Cross Country Mountain Biking	Elite	Novice
CLINICS Check the following Instructional Clinics you are registering to participate in, if any:
June 22, 2012 – Extremity Games Main Event Clinics (Free Events)
Skateboarding
Wakeboarding
Kayaking
Speed Rock Climbing
Cross Country Mountain Biking
Mixed Martial Arts
Powerlifting
To be officially registered for competition, you must complete the second page of the registration, which includes payment of the registration fee.