Register for Young Athletes - Special Olympics New Jersey

Play at Home

What do young children learn while playing?

Language (verbal and nonverbal)
Social skills like taking turns or making eye contact
Emotional skills like learning how to react when you lose a game
School readiness skills such as color and number recognition

What do young children learn about their families when they play at home?

That they are loved
To trust their family
Self confidence
That they are safe and cared for
How to be healthy
And how to have FUN!

Free Resources

This is the FREE Activity Guide that you receive in the mail. The Activity guide gives you fun ideas for playing at home.

Looking for more games?
Head over to the Family Resource videos.

Versión en español disponible

Young Athletes Registration Form

Athlete Information

First Name

Last Name

Birthdate (mm/dd/yyyy)

Gender

MaleFemale

Registrant Type:

Additional Information

Does this Athlete have? (check all that apply)

AutismCerebral PalsyDown SyndromeFetal Alcohol SyndromeFragile X SyndromeUnidentified

Other:

Please Mark Items you would Special Olympics to know:

Requires wheelchair accessibilityMedical conditionSpecial Diet/Allergies

Other:

Parent/Guardian Information

First Name

Last Name

I prefer communication in:

EnglishSpanish

Email Address

Phone Number

Mailing Address (House #, Street, Apt #)

City

State

Zip Code

How did you hear about the Young Athletes Program?

SchoolEarly InterventionInternet/WebsiteFriendOther:

Young Athletes Kit Request (One Kit per household)

Young Athletes Home Kits are for new registered Young Athletes only

Due to the Coronavirus outbreak, Kit order requests maybe delayed. All orders are processed through Flaghouse and will be delivered to your home address.

Do you need a Young Athletes Kit?

Yes

Is your mailing address the same as listed above?

Yes

Young Athletes Kit Request

Please complete the following to request kit for your New Young Athlete.
PLEASE NOTE: kit order requests might be delayed.

Basic Information

Contact Information

First Name

Email Address

Program Name

Address

Address Line 1

Address Line 2

City

State

Zip Code

Release Form:

I am the parent or guardian of the Young Athlete named above and agree to the following:

1. Able to Participate. The Young Athlete is able to take part in Special Olympics. I understand there is a risk of injury.

2. Photo Release. Special Olympics organizations may use the Young Athlete’s picture, video, name, voice and words to promote Special Olympics.

3. Emergency Care: If a medical emergency should arise during the Young Athlete’s participation in Special Olympics activities at a time when a parent or guardian is not present to make medical decisions, I consent to medical care for the Young Athlete if needed, unless I check one of these boxes:

I have a religious or other objection to the Young Athlete receiving medical treatment.

I consent to emergency medical care, but I do not consent to blood transfusion for the Young Athlete.

(If either box is checked, an EMERGENCY MEDICAL CARE REFUSAL form will be sent and MUST be completed)

4. Health Programs. If the Young Athlete takes part in a Special Olympics health program, I consent to health activities, exams and treatment for the Young Athlete. This should not replace regular health care. I can say no to treatment or anything else at any time for the Young Athlete.

5. Personal Information. I understand personal information may be used and shared by Special Olympics to:

Make sure Young Athletes can participate safely;
Run training and events and share results;
Put the Young Athletes information in a computer system;
Provide health treatment, make referrals, consult doctors, and remind me about follow-up services;
Research, share and respond to needs of the Special Olympics participants (identifying information removed if shared publicly); and
Protect health and safety, respond to government requests, and report information required by law.
I can ask to see and change the Young Athlete’s information. I can ask to limit how the information is used.

6. Concussions. I understand there is a risk of concussions and continuing to play sports with a concussion. The Young Athlete may have to get medical care if a concussion is suspected. The Young Athlete may also have to wait 7 days or more and get permission from a doctor before he/she starts playing sports again.

I am the parent/guardian of the participant named on this registration form. I have read and fully understand the provisions of the above release. Through my signature on this release form, I am agreeing to the above provisions on my own behalf and on the behalf of the participant named above to participate in Special Olympics games, recreation programs and physical activity programs.

Parent/Guardian Signature

Date

High Risk Waiver & COVID-19 Code of Conduct

Participant Information

Participant Full Name

Participant Birth Date (mm/dd/yyyy)

Participant Role

AthleteUnified PartnerCoachVolunteer

Area/County

Email Address

Phone

Phone Type

HomeMobile

Who is at Higher Risk Of COVID-19?

COVID-19 is a new disease and information is changing on who is more likely to get COVID-19 and who is will have more complications. Based on currently available information and clinical expertise, people with intellectual and developmental disabilities may be at higher risk of severe illness resulting in death from COVID-19.

In order to participate, you must sign the High Risk Waiver (if applicable) and the COVID-19 Code of Conduct Waiver.

Current clinical guidance and information from the U.S. Centers for Disease Control and

Prevention (CDC) and World Health Organization (WHO) lists those at high risk for severe illness from COVID-19 as:

People 65 years and older. Risk increases with age.
People who live in a nursing home or licensed long-term care facilities

Regardless of age, individuals with underlying conditions, such as the following, are or maybe at increased risk of severe illness from COVID-19:

People with chronic lung disease, chronic obstructive pulmonary disease or moderate to severe asthma
People who have serious heart conditions (including heart failure, coronary artery disease, congenital heart disease, cardiomyopathy, hypertension)
People who are immunocompromised

Many conditions can cause a person to be immunocompromised, including cancer treatment, smoking, bone marrow or organ transplantation, immune deficiencies, poorly controlled HIV or AIDS, and prolonged use of corticosteroids and other immune weakening medications

People with obesity (body mass index [BMI] of 30 or higher). To calculate BMI, refer to: https://www.cdc.gov/healthyweight/assessing/bmi/adult_bmi/english_bmi_calculator/bmi_calculator.html
People with diabetes (Type 1 and 2)
People with chronic kidney disease
People with liver disease
People with dementia
People with Down Syndrome

The list may change as evidence is learned. Please review the latest list of conditions that put individuals at increased risk available at the CDC website (https://bit.ly/2VEJcSK)

If you are at a high risk, you may be putting yourself at risk when you return to activities with Special Olympics New Jersey. But, you may also put your family and your teammates at risk. If you have these conditions, you should seek additional medical advice prior to returning.

If you have been diagnosed with COVID-19, you should consult with a healthcare professional for written medical clearance before returning to Special Olympics in person activities as serious cardiac, respiratory, and neurological issues may develop as a result of COVID-19.

High Risk Waiver

Are you high risk as outlined above?

YesNo

COVID-19 Code of Conduct Waiver
I understand I could get COVID-19 through sports, training, competition and/or any group activity at Special Olympics New Jersey. I am choosing to participate in sports, competition and/or other Special Olympics New Jersey activities at my own risk.

During the time these precautions are needed, I agree to the following to help keep me and my fellow participants safe by checking all of the boxes below. Failure to complete COVID-19 Code of Conduct will result in no in-person participation allowed.

If I have COVID-19 symptoms, I will stay at home and NOT go to any activities until 7 days after all of my symptoms are over. If I am exposed to COVID-19 and have no symptoms, I can return 14 days after exposure.

Special Olympics New Jersey gave me education on Special Olympics New Jersey rules for COVID-19 and who is at high risk

I know that if I have a high risk condition, I have a greater chance that I could get sick or die from COVID-19. If I have a high risk condition, I should not go to Special Olympics New Jersey events in person, until there is little or no COVID-19 in my community.

I have reviewed the Who is at Higher Risk document.

I understand I would be considered High Risk as outlined in the High Risk Waiver. I understand that I can choose to participate within the parameters Special Olympics New Jersey has outlined in the Return to Activity Plan. I have made an individual risk assessment and have agreed to continuing my participation. I have signed the High Risk Waiver.

I know that before or when I get to a Special Olympics New Jersey activity, they will ask me some questions about symptoms and exposure to COVID-19. They may also take my temperature. I will answer truthfully and participate fully.

I will keep at least 6 feet from all participants at all times.

I will wear a mask at all times while at Special Olympics New Jersey activities. I may not have to wear it during active exercise.

I will wash my hands for 20 seconds or use hand sanitizer before any activities. I will wash my hands any time I sneeze, cough, go to the bathroom or get my hands dirty.

I will avoid touching my face. I will cover my mouth when I cough or sneeze and immediately wash my hands after.

I will not share drinking bottles or towels with other people.

I will only share equipment when instructed to. If equipment must be shared, I will only touch the equipment if it is disinfected first.

If I get or have had COVID-19, I will not go to any in-person Special Olympics New Jersey events until 14 days after my symptoms end. I will go to my doctor and get written clearance before returning to any sport or fitness activities.

I understand that if I do not follow all of these rules, I may not be allowed to participate in Special Olympics New Jersey activities during this time.

I HAVE READ ALL OF THIS AGREEMENT OR HAVE HAD IT READ TO ME AND AGREE TO FOLLOW THESE ACTIONS. Failure to complete COVID-19 Code of Conduct will result in no in-person participation allowed.

Signature Type

Participant Signature (Required for adult (age 18 and older) participants, including adult athlete with capacity to sign documents - e.g. the athlete is their own guardian)Parent/ Guardian Signature (Required for participant who is a minor (younger than age 18) or lacks capacity to sign documents.)

Participant Signature

Required for adult (age 18 and older) participant, including adult athlete with capacity to sign documents.
By signing this, i acknowledge that I have completely read and fully understand the information in this form.

Signature

(By signing this Code of Conduct Waiver electronically, you agree your electronic signature is the legal equivalent of your manual signature.)

Today's Date (MM/DD/YYYY)

Parent/Guardian Signature

Required for participant who is a minor (younger than the age 18) or lacks capacity to sign documents.
I am a parent or guardian of the athlete/participant named above. I have read and understand this form and have explained the contents to the participant as appropriate. By signing, I agree to this form on my own behalf and on behalf of the participant.

Parent/Guardian Signature

(By signing this Code of Conduct Waiver electronically, you agree your electronic signature is the legal equivalent of your manual signature.)

Today's Date (MM/DD/YYYY)

Relationship

Email Address

Phone

Phone Type

HomeMobile

Communicable Diseases Waiver

Participant Information

Participant Full Name

Participant Birth Date (mm/dd/yyyy)

Participant Role

AthleteUnified PartnerCoachVolunteer

Area/County

Email Address

Phone

Phone Type

HomeMobile

Waiver and Release of Liability, Assumption of Risk and Indemnification Agreement for Communicable Diseases ("Agreement") for Special Olympics New Jersey

In consideration of being allowed to participate in any way in Special Olympics sports training, competition or fundraising activities, the undersigned acknowledges, appreciates, and agrees that:

Participation includes possible exposure to and illness from infectious and/or communicable diseases including but not limited to MRSA, influenza, and COVID-19. While particular rules and personal discipline may reduce this risk, the risk of serious illness and death does exist; and,

I KNOWINGLY AND FREELY ASSUME ALL SUCH RISKS, both known and unknown, EVEN IF ARISING FROM THE NEGLIGENCE OF THE RELEASEES or others, and assume full responsibility for my participation; and,

I willingly agree to comply with the stated and customary terms and conditions for participation as regards protection against infectious diseases. If, however, I observe and any unusual or significant hazard during my presence or participation, I will remove myself from participation and bring such to the attention of the nearest official immediately; and,

I, for myself and on behalf of my heirs, assigns, personal representatives and next of kin, HEREBY RELEASE AND HOLD HARMLESS Special Olympics, Inc, Special Olympics New Jersey, their officers, officials, agents, and/or employees, other participants, sponsoring agencies, sponsors, advertisers, and if applicable, owners and lessors of premises used to conduct the event ("RELEASEES"), WITH RESPECT TO ANY AND ALL ILLNESS, DISABILITY, DEATH, or loss or damage to person or property, WHETHER ARISING FROM THE NEGLIGENCE OF RELEASEES OR OTHERWISE, to the fullest extent permitted by law.

Signature Type

Participant Signature

Required for adult (age 18 and older) participants, including adult athlete with capacity to sign documents.
I HAVE READ THIS RELEASE OF LIABILITY AND ASSUMPTION OF RISK AGREEMENT, FULLY UNDERSTAND ITS TERMS, UNDERSTAND THAT I HAVE GIVEN UP SUBSTANTIAL RIGHTS BY SIGNING IT, AND SIGN IF FREELY AND VOLUNTARILY WITHOUT ANY INDUCEMENT.

Signature

(By signing this Communicable Diseases Waiver electronically, you agree your electronic signature is the legal equivalent of your manual signature.)

Today's Date (MM/DD/YYYY)

Parent/Guardian Signature

For participants of minority age (under age 18 at the time of registration) or those over 18 without the capacity to sign for themselves.

This is to certify that I, as parent/guardian with legal responsibility for this participant, have read and explained the provisions in this waiver/release to my child/ward including the risks of presence and participation and his/her personal responsibilities for adhering to the rules and regulations for protection against communicable diseases. Furthermore, my child/ward understands and accepts these risks and responsibilities. I for myself, my spouse, and child/ward do consent and agree to indemnify and hold harmless the Releases for any and all liabilities incident to my minor child's/ward's presence or participation in these activities as provided above, EVEN IF ARISING FROM THEIR NEGLIGENCE, to the fullest extent provided by law.

Parent/Guardian Signature

(By signing this Communicable Diseases Waiver electronically, you agree your electronic signature is the legal equivalent of your manual signature.)

Today's Date (MM/DD/YYYY)

Relationship

Contact Information