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.**


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
















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




EMERGENCY CONTACT INFORMATION




BACKGROUND INFORMATION (only required for participants 16 years and older)
**Please answer all of the following questions:





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.

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.**


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








COVID-19 CODE OF CONDUCT WAIVER

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
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

You hereby release and agree to hold Special Olympics New Jersey harmless from any and all claims and causes of action for damages, costs, and/or expenses that may arise from any actions or inactions by Special Olympics New Jersey that you believe resulted in injury to you related to COVID-19. You understand that you are discharging Special Olympics New Jersey from any liability or claim that you, your heirs or personal representatives may have against Special Olympics New Jersey for any claim for bodily injury, illness, medical treatment or other damage that may relate to COVID-19. This liability waiver and release extends to Special Olympics New Jersey and its employees, volunteers and representatives.

Participant Signature
Required for adult (age 18 and older) participants, including adult athlete with capacity to sign documents.
I have read and understand this waiver. If I have questions, I will ask. By signing, I agree to this waiver. 

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

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

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


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
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.
 
You hereby release and agree to hold Special Olympics New Jersey harmless from any and all claims and causes of action for damages, costs, and/or expenses that may arise from any actions or inactions by Special Olympics New Jersey that you believe resulted in injury to you related to COVID-19. You understand that you are discharging Special Olympics New Jersey from any liability or claim that you, your heirs or personal representatives may have against Special Olympics New Jersey for any claim for bodily injury, illness, medical treatment or other damage that may relate to COVID-19. This liability waiver and release extends to Special Olympics New Jersey and its employees, volunteers and representatives.

Participant Signature
Required for adult (age 18 and older) participants, 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 

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

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

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





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:

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.

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

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. 

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


COVID-19 VACCINE INFORMATION

Special Olympics New Jersey is asking participants if they have received the COVID-19 vaccination as well as the date of their last shot. This information is for data collection purposes ONLY and will not prohibit participation.   

This form only has to be filled out ONCE.