Athlete Interest FormIf you are interested in becoming a Special Olympics Ontario athlete please fill out the form below. A member of Special Olympics Ontario will be in touch with you soon to help you register with a local program. Athlete Name(Required) First Last Intellectual Disability(Required)Does the individual that is interested in becoming a Special Olympics Athlete have an Intellectual Disability? I don't knowYesNoEmailPlease let us know what e-mail address we can reach you at. Enter Email Confirm Email Phone(Required)Please let us know what phone number we can reach you at. Address(Required) Street Address Address Line 2 City AlbertaBritish ColumbiaManitobaNew BrunswickNewfoundland and LabradorNorthwest TerritoriesNova ScotiaNunavutOntarioPrince Edward IslandQuebecSaskatchewanYukon Province Postal Code Athlete Date of Birth(Required) MM slash DD slash YYYY Gender(Required)Please let us know which gender you identify with Female Male Other Prior Special Olympics Involvement(Required)Has the potential athlete been involved in Special Olympics before? I don't knowYesNoSO InvolvementPlease let us know how the potential athlete was involved in Special Olympics in the past. Sport Interest(Required)Please indicate which sports the potential athlete would be interested in participating in. (Please note: not all sports are available in all communities) Alpine Skiing Athletics (Track & Field) Basketball Bocce Cross-Country Skiing Curling Figure Skating Five Pin Bowling Floor Hockey Golf Powerlifting Rhythmic Gymnastics Snowshoeing Soccer Softball Speed Skating Swimming Ten Pin Bowling Kayaking Cricket Other OtherPlease let us know what other program/sport you are interested in Emergency Contact InformationPlease let us know who to contact in case of an emergancy for this athlete. Emergency Contact Name(Required) First Last Emergency Contact Phone(Required)Emergency Contact Email Enter Email Confirm Email Terms & ConditionsBy completing the following fields, the undersigned acknowledges that they have viewed and agreed to the Special Olympics policies which are mandatory for participation. The full documents can be found below this form. Waiver(Required) I have viewed and agree to the terms set out in the special Olympics Participation Waiver Criminal Offense(Required)Have you ever been charged/convicted of any criminal offense as outlined in the Special Olympics Participation Waiver [Part 1: Health and Safety (Section 3)]?Yes- I have been charged/convicted of a criminal offenseNo- I have NOT been charged/conviceted of a criminal offenseMedia Release(Required)I have viewed the Special Olympics Participation Waiver [Part 2: Promotional Media Opt-Out] and grant permission to Special Olympics to use my name, likeness, voice, and/ or wordsYesNoPrivacy Policy(Required) I have viewed and agree to the terms set out in the Special Olympics Privacy Policy Code of Conduct(Required) I have viewed and agree to the terms set out in the Special Olympics Code of Conduct SignatureHiddenEnrollment InformationThis section is filled out by the community council to indicate which programs the athlete above is to be enrolled in. HiddenCommunity Council Best Contact HiddenContactPlease indicate if we are to enroll the above athlete into your community programs or not. Please use the notes section below if more information needs to be communicated. I have been in touch with the above athlete and they are to be enrolled in our local community programs I have been in touch with the above athlete and they will not be enrolling in our programs This athlete is already registered with our programs (please see notes below) HiddenSOO Community to Enroll Athlete in HiddenSport EnrollmentPlease indicate which sports the above athlete has been approved to be enrolled in. Alpine Skiing Athletics (Track & Field) Basketball Bocce Cross-Country Skiing Curling Figure Skating Five Pin Bowling Floor Hockey Golf Powerlifting Rythmic Gymnastics Snowshoeing Soccer Softball Speed Skating Swimming Ten Pin Bowling Kayaking Cricket Pickleball Volleyball Canoe/Kayak HiddenOtherPlease indicate if there are other programs not listed above that the athlete has been approved to be enrolled in. HiddenNotesHiddenName of Individual completing the enrollment section First Last HiddenData InputThis section is to be filled out by SOO staff to confirm the input of the new member into the Database. HiddenName of Staff Member that completed the input First Last HiddenDate input was completed MM slash DD slash YYYY HiddenNotes Participation WaiverPrivacy PolicyCode of Conduct
