Registration Type (mark one or both) *

Volunteer

Unified Partner

Are you new or re-registering? *

New volunteer

Re-registering

What role interested you? Click all that apply.

Coaching

Sports Coordinator

Team Management

Event Management

Social Media Coordinator

Fundraising

Unified Athlete

Event Volunteer (awards, scorekeeping, timing etc.)

Unified Champion School Liaison

Name *

First Name

Last Name

Date of Birth *

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DD

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Gender *

Male

Female

Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Phone *

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Language(s) (Optional):

Mark all that apply

English

Spanish

Other:

Parent/Guardian Name

First Name

Last Name

Parent/Guardian Address

(If different then above)

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Parent/Guardian Phone

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Acknowledgement *

I understand: Special Olympics Idaho preforms a background check on all volunteers over the age of 18. We do not keep your Social Security number on file. All volunteers over the age of 18 must pass a background check through our background check vendor, Sterling Volunteers. After receiving the completed application, you will receive a separate email from Sterling Volunteers inviting you to log in to their secured, on-line portal and begin the background check process. I understand that I am not authorized to volunteer until my background check is complete.

Health History *

Please mark if you have any of the following conditions:

Special Dietary Needs

Allergies

Assistive or Implantable Devices

High Blood Pressure

Heart Condition

Asthma or Respiratory Condition

Mental Health Condition

Epilepsy or Seizure Disorder

Neurological Condition

Diabetes

Sickle Cell Anemia/Trait

Chronic Infection

Missing Organ

Other Health Condition

NONE

Protective Behaviors: Class A Volunteers and Unified Partners who are 18 years of age and older are required to complete the online Protective Behaviors training, unless they are a current high school student. Access the Protective Behaviors training at www.specialolympics.org/protectivebehaviors *

I agree

Volunteer Information *

CLASS A VOLUNTEER & UNIFIED PARTNER REGISTRATION I agree to the following: 1. Ability to Participate. I am physically able to take part in Special Olympics activities. 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. Risk of Concussion and Other Injury. I know there is a risk of injury. I understand the risk of continuing to participate with or after a concussion or other injury. I may have to get medical care if I have a suspected concussion or other injury. I also may have to wait 7 days or more and get permission from a doctor before I start playing sports again. 4. 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. 5. Health Programs. If I take part in a health program as a participant, I consent to health activities, screenings, and treatment. This should not replace regular health care. I can say no to treatment or anything else at any time. 6. 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: • 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. • using my personal information for communications and marketing purposes, including direct digital marketing through email, text message, and social media. • sharing my personal information with (i) researchers, such as universities and public health agencies, that are studying intellectual disabilities and the impact of Special Olympics activities, (ii) medical professionals in an emergency, and (iii) government authorities for the purpose of assisting me with any visas required for international travel to Special Olympics events and for any other 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. 7. Background Check Authorization. [APPLIES TO ADULTS ONLY] I authorize Special Olympics to conduct a background check on me. This background check may be done through a third party. The background check may include an inquiry into my employment, education, driving, and/or criminal history. I understand that Special Olympics may rely on information provided or discovered to determine whether I may participate in Special Olympics activities. By signing below, I authorize investigators to conduct a background check as described in this form. I further authorize any third parties or agencies who may be in possession of the requested information, to disclose such information in connection with this background check. 8. 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.

I have read, understand and agree to the above.

Todays Date *

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