Volunteers Class B Form and Waivers - Special Olympics New Jersey

updated 8/30/21

SPECIAL OLYMPICS NEW JERSEY CLASS B VOLUNTEER FORM

Class B Volunteers are volunteers who only have limited contact with athletes or who have contact with athletes accompanied by coaches and chaperones. Volunteers with more intensive activities and responsibilities should complete Class A Volunteer registration. For more information on Class A registration, please contact volunteer@sonj.org.

**This form needs to be renewed every three (3) years.**

If you have completed in the past 3 years, do not complete again.

Class B Volunteers must be at least 14 years old, unless otherwise noted.

Complete this form if you are age 18+ and your own legal guardian. If you are under age 18 and/or are not your own legal guardian, a parent/legal guardian must fill this out on your behalf.

VOLUNTEER INFORMATION

Participant First Name

Last Name

Birth Date

Gender

Address

City

State

Zip Code

Phone

Phone Type

E-mail

Please select your Area

Are you a certified Sport Official/Referee

YesNo

Are you a Law Enforcement Officer?

YesNo

Agency Name

What sport?

Disability

What are you volunteering for?

(Ex: Area 03 bowling, Soccer league, Fall Games)

Organization/School:

Race/Ethnicity

Primary Language: Choose 1

EnglishSpanish Prefer not to answer

Others (please list):

EMERGENCY CONTACT INFORMATION

Full Name

Relationship

Phone

Phone Type

BACKGROUND INFORMATION (only required for participants 16 years and older)

**Please answer all of the following questions:

Do you use illegal drugs?

YesNo

Have you ever been convicted of a criminal offense?

YesNo

Have you ever been charged with and/or convicted of neglect, abuse or assault?

YesNo

Has your driver's license ever been suspended or revoked?

YesNo

If you answered YES to any of the above, please explain. If you answered NO for all the above, enter N/A.

Agreement

I agree to the following:

1. Ability to Participate. I am physically able to take part in Special Olympics activities. I know there is a risk of injury.

2. Likeness Release. I give permission to Special Olympics, Inc., Special Olympics games/local organizing committees, and Special Olympics accredited Programs (collectively “Special Olympics”) and Special Olympics partners and sponsors to use my likeness, photo, video, name, voice, words, and biographical information to promote Special Olympics, raise funds for Special Olympics, and acknowledge partners’ and sponsors’ support for Special Olympics.

3. Emergency Care. If I am unable, or my guardian is unavailable, to consent or make medical decisions in an emergency, I authorize Special Olympics to seek medical care on my behalf.

4. Personal Information. I understand that Special Olympics will be collecting my personal information as part of my participation, including my name, image, address, telephone number, health information, and other personally identifying and health related information I provide to Special Olympics (“personal information”).

• I agree and consent to Special Olympics:

o using my personal information in order to: make sure I am eligible and can participate safely; run trainings and events; share competition results (including on the Web and in news media); provide health treatment if I participate in a health program; analyze data for the purposes of improving programming and identifying and responding to the needs of Special Olympics participants; perform computer operations, quality assurance, testing, and other related activities; and provide event-related services.

o using my personal information for communications and marketing purposes, including direct digital marketing through email, text message, and social media.

o sharing my personal information with (i) medical professionals in an emergency, and (ii) government authorities for any purpose necessary to protect public safety, respond to government requests, and report information as required by law.

• I have the right to ask to see my personal information or to be informed about the personal information that is processed about me. I have the right to ask to correct and delete my personal information, and to restrict the processing of my personal information if it is inconsistent with this consent.

• Privacy Policy. Personal information may be used and shared consistent with this form and as further explained in the Special Olympics privacy policy at www.SpecialOlympics.org/Privacy-Policy.aspx.

5. Waiver and Liability Release. I understand the risks involved with participation in Special Olympics activities. I fully accept and assume all such risks and all responsibility for losses, costs, and damages I may incur as a result of my participation. I hereby release and agree not to sue any Special Olympics organization, its directors, agents, volunteers, and employees, and other participants (“Releasees”) related to any liabilities, claims, or losses on my account caused or alleged to be caused in whole or in part by the Releasees. I further agree that if, despite this release, I, or anyone on my behalf, makes a claim against any of the Releasees, I will indemnify and hold harmless each of the Releasees from any such liabilities, claims, or losses as the result of such claim. I agree that if any part of this form is held to be invalid, the other parts shall continue in full force and effect.

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.)

VOLUNTEER SIGNATURE (required for adult with capacity to sign legal documents)

**I have read and understand this form. If I have questions, I will ask. By signing, I agree to this form.**

Volunteer Signature (Legal Name)

Today's Date (MM/DD/YYYY)

PARENT/GUARDIAN SIGNATURE (required for participant who is a minor or lacks capacity to sign legal documents)

**I am a parent or guardian of the participant. 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

Relationship

Today's Date (MM/DD/YYYY)

PARENT/GUARDIAN INFORMATION (required if minor or otherwise has a legal guardian)

Full Name

Same Contact Information as Volunteer

Address

City

State

Zip Code

Phone

Phone Type

E-mail

COMMUNICABLE DISEASES WAIVER

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 Releasees 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