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New Athlete Information Request Form

 

Please complete this form to request a registration packet for a New Athlete to get involved in our program.

IMPORTANT NOTE: Completing this form DOES NOT complete the registration process for an athlete to be eligible for Special Olympics participation. The potential athlete's physician still must complete a Athlete Medical Release Form before and athlete can begin training or competing in the program.

CURRENT SPECIAL OLYMPICS COACHES: Completing this form DOES NOT register an athlete or athletes for a specific Special Olympics Kentucky competition. Please contact the proper Program Director for event registration information.

Athlete First Name Athlete Last Name
School/Organization
Mailing Address

City State Zip Code
County

Home Phone Work Phone Cell Phone
E-mail Address

Other Information
Date of Birth
Sex Male Female


Have you ever participated in Special Olympics?

  Yes No  
Does athlete have a current Special Olympics Kentucky Medical?
  Yes No  
Please check the sports in which you are interested:
  Fall Sports (August-December)
Bowling Equestrian  

  Winter Sports (November-March)
  Alpine Skiing Basketball Cheerleading  
  Figure Skating Snow Shoeing    

  Spring Sports (February-June)
  Aquatics Bocce Gymnastics  
  Powerlifting Track & Field 5 a-side Soccer  

  Summer Sports (June-September)
  Golf Softball    

Parent/Guardian Information:

First Name Last Name
Organization
Mailing Address

City State Zip Code
Home Phone Work Phone Cell Phone
E-mail Address

Have you ever participated in Special Olympics?
    Yes  
Are you interested in coaching Special Olympians?
    Yes  
Are you interested in chaperoning Special Olympians?
    Yes  
Would you like to volunteer at a competition/tournament?
    Yes  
Would you be interested in fundraising for Special Olympics?
    Yes  
Would you like to receive information on how to contribute to Special Olympics?
    Yes  

Enter any additional comments in the space provided below:

IMPORTANT NOTE: Submitting this form DOES NOT complete the registration process for an athlete to be eligible for Special Olympics participation. The potential athlete's physician still must complete a Athlete Medical Release Form before and athlete can begin training or competing in the program.

CURRENT SPECIAL OLYMPICS COACHES: Submitting this form DOES NOT register an athlete or athletes for a specific Special Olympics Kentucky competition. Please contact the proper Program Director for event registration information.



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Revised Monday, December 7, 2009

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