Register for Young Athletes - Special Olympics New Jersey

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Play At Home

Young Athletes At-Home Activity Tracker Program

Our 8-week program allows you to track your activities and progression of your child from the comfort of your home using your Home Kit or household items. This program option offers the best combination of sport and play to enjoy as a family!

Program Materials:

Weekly Tracker Sheets
Online resources and support
Young Athletes Activity Guide and Flashcards – digitally provided
Household Items List

Play in the Community

Play as a family and meet new friends!

Weekly guided sport and play sessions
All programs are led by trained coaches and volunteers
Play Unified (sibling without an intellectual disability)
Play together in your community in your local area
Attend special Young Athletes Events

What will your Young Athlete learn while playing?

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

Young Athletes Registration Form

Versión en español disponible

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:

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

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 - 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) 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