Athlete Registration Form – Special Olympics New Zealand

Dear Special Olympics Athletes, Parents, and Guardians:

Through the power of sport our athletes find joy, confidence and fulfillment - on the playing field and in life. Whether you are new to Special Olympics or have been involved for years, we are excited you are part of the movement!

To register or re-register as a Special Olympics Athlete, please complete the registration form.

It takes approximately 10 minutes to complete the form.

Please note that the form is unable to be saved and completed in sessions, it must be completed in one sitting.

If you have any questions please contact admin@specialolympics.org.nz or call us at 04-560-0360

Please Note: As we transition to online registrations you may experience technical issues, we continue to work to fix these and apologize for any inconvenience. Please contact admin@specialolympics.org.nz if you experience any problems.

Before continuing, please ensure you have completed the following:

You have had your general health practitioner complete a medical form (download below) that has your physician's stamp, and is signed and dated within 3 months of today's date. (Note: Medical Form must be in PDF format for upload)

If you are a new athlete, you have attended at least one SONZ training*

*We recommend going to a Special Olympics training before registering as an athlete, contact a club in your area to attend a training.

Enable Club Emails

Pre-Registration Check

Before starting the registration form please ensure you have completed the following pre-registration check.

Are you a new athlete to Special Olympics New Zealand or are you re-registering? *

New Athlete
Re-Registering

Do you have a legal guardian? *

Yes
No

Are you under 18-years-old? *

Yes
No

Before starting the athlete registration confirm that you have completed the following:

I have completed a medical form that has my physician's stamp and has been signed and dated within 3 months of today's date. *

Yes

Medical Information

Please ensure that the medical form has your physician's stamp and is signed and dated within 3 months of today's date on page 4.

Note: Your medical form must be PDF format to be uploaded.

Upload Completed Medical Form (pdf) *

If you have not completed a medical form, download it here and complete it before continuing

Are there any behavioural or medical issues, or other restrictions that we should be made aware of that may impact the wellbeing of the athlete in our care or the safety of others? *

Yes
No

Athlete Information

Club you are applying to join: *

First Name: *

Middle Name:

Last Name: *

Preferred Name:

Date of Birth *

Day/Month/Year

Gender: *

Female
Male
Other

Language(s) spoken:

Do you have a residential care provider? *

Yes
No

Athlete Contact Information

Address *

Address Line 1

Suburb *

Suburb

City *

City

Post Code *

Post Code

Add a contact phone number(s): *

Home Phone
Mobile Phone

Email Address:

PARENT / CAREGIVER DETAILS

(required if athlete is under 18 or otherwise has a legal guardian)

Parent/caregiver details are not required as athlete is over 18-years old and/or has a legal guardian.

If this information is incorrect return to the pre-registration check page

Address *

Address Line 1

Parent / Caregiver Suburb *

Suburb

Parent / Caregiver City *

City

Parent / Caregiver Post Code *

Post Code

Add a contact phone number(s): *

Home Phone
Mobile Phone

Email Address: *

EMERGENCY CONTACT INFORMATION

Name: *

Add a contact phone number(s): *

Home Phone
Mobile Phone

Relationship: *

ATHLETE WAIVER and CODE OF CONDUCT

I agree to the following:

Waiver

1. Ability to Participate.
I state that I am physically able to participate in Special Olympics New Zealand (SONZ) activities

2. Risk of Neck Problems
I understand that if a doctor has found problems with my neck (Atlanto-Axial Instability) I will only be allowed to participate in Special Olympics Sports if I have another examination and the docter who checks me for my neck problems says I am able to participate and I sign a form to say I understand what the doctor has told me.

3. Personal Information.
I consent to SONZ collecting, retaining, using and disclosing personal and medical information for the purpose of involving me in the Special Olympics Programme, including the Healthy Athletes Programme. I acknowledge my right to access and amend this information. This is given in accordance with the Privacy Act 1993.

4. Health Programs.
If I take part in a health program, I consent to health activities, screenings and treatment. This should not replace regular health care.

5. Likeness Release.
I give Special Olympics permission to use my photograph, video, name, voice or words to promote Special Olympics.

6. Emergency Care.
If I need emergency medical care while I am participating in Special Olympics Activities I give permission to Special Olympics to do whatever may be necessary to protect my health and well-being, which may include emergency medical care and hospitalisation. If you have religious objections to receiving such emergency medical treatment, please complete the Religious Objections form. and upload it below.

Do you need to upload a religious objections form? *

Yes
No

Code of Conduct

I will be a good sportsperson at all times, respect my coache(s),other athletes, unified partners and volunteers.

I will not use bad language, I will not verbally abuse, phyiscally fight or challenge anyone involved in Special Olympics.

I will train regulary, try my best to learn and follow the rules, listen to my coach(es) and sports officials and ask questions when I don't understand.

I shall perform to the best of my ability during training, divisioning and competitions.

I will take full responsibility for my actions and will not make any inappropriate or unwanted physical, verbal or sexual advances to others.

I will not drink alcohol, smoke or take illegal drugs while representing Special Olympics at training sessions, competitions or during Games.

I will not take any drugs for the purpose of improving my performance.

I understand that SONZ may take disciplinary measures if I breach the Code of Conduct and I may be subject to a range of consequences up to and including not being allowed to participate in Special Olympics training, events and activities.

Athlete Signature

(Required for adult athletes with capacity to sign legal documents)

Athlete Name: *

I have read and understood this form. If I have questions, I will ask. By signing, I agree to this form and confirm that the information I have provided is true and correct.

Athlete Signature: *

Type your full name above to sign this registration form.

Date: *

If you would like to be emailed a copy of your registration form, add a contact email address below.

Note: The confirmation email may end up in your Junk Mail Inbox

Note: it may take between 1-2 minutes for your registration form to be submitted.

Dear Special Olympics Athletes, Parents, and Guardians:

Pre-Registration Check

Medical Information

Athlete Information

Athlete Contact Information

PARENT / CAREGIVER DETAILS

EMERGENCY CONTACT INFORMATION

ATHLETE WAIVER and CODE OF CONDUCT

Waiver

Code of Conduct

Athlete Signature

Parent/Guardian Signature