Every athlete must complete the appropriate application every three years:

Application for Participation Instructions:

Page 1: Basic Demographic Information

This should be filled out by the athlete, parent, guardian or caretaker.

Page 2: Athlete Release Form

The second page of the application provides consent to participate in SONH events, consent to be treated medically should the need arise and consent to allow SONH (and/or our supporters) to use the athletes name and likeness to promote activities of Special Olympics, among other details.

This page must be signed and dated by either the adult athlete that is his/her own guardian or the athlete’s guardian.

Pages 3 & 4: Health History

The third and fourth page of the application is to be completed by the athlete or parent, guardian or caretaker and brought to the exam. Health history is important for SONH to have for two reasons: (a) to have medical information on hand during training and competition, in case of a medical emergency; and (b) to ensure that the physician has information of the athlete’s health history when performing the exam.

Page 5: Physical Exam

In order to process an Athlete Application for Participation, page five of the application MUST be signed by a certified medical professional who is qualified to conduct physical exams and prescribe medications. An athlete’s compliance is based on the date of the medical professional’s signature. A print out from the doctor’s office cannot be substituted for the signature on the SONH application because there is specific, Special Olympics related language in our form which makes it different than a print out or other type of release

Supplemental Forms

Atlanto-Axial Instability (AAI) Special Release Form

Only to be completed if symptoms of spinal cord compression or Atlanto-axial instability were found in pre-participation exam and a doctor then provided clearance for participation on page five of application for participation.

Emergency Medical Care Refusal Form Refusal (Parent/Guardian Signature)

Should only be completed if a legal guardian does not consent to emergency medical care on religious or other grounds and has marked a box under the Emergency Care provision on page two of application for participation.

Emergency Medical Care Refusal Form (Athlete Signature)

Should only be completed if an athlete does not consent to emergency medical care on religious or other grounds and has marked a box under the Emergency Care provision on page two of application for participation.


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