Section 1 of 3
Northeast Region - Volleyball Sign-up Form
Thank you for taking the time to sign-up for Volleyball.
Signing up is REQUIRED for any interested athletes, unified partners or volunteers.
IMPORTANT: Signing up to participate in this sport does not guarantee participation, as participation is dependent upon an adequate number of volunteers to ensure we provide safe and meaningful sports training.
Once your form is submitted, you will receive a confirmation email with more information.
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I understand I could get Coronavirus through in-person sports, training, competition and/or any group activity at Special Olympics Pennsylvania. I am choosing to participate in sports, training, competition and/or other Special Olympics Pennsylvania activities at my own risk.
I understand I could get Coronavirus through in-person sports, training, competition and/or any group activity at Special Olympics Pennsylvania. I am choosing to participate in sports, training, competition and/or other Special Olympics Pennsylvania activities at my own risk.
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Yes
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First Name:
First Name:
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This should be the name of the athlete, unified partner or volunteer that is signing up TO PARTICIPATE.
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Last Name:
Last Name:
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This should be the name of the athlete, unified partner or volunteer that is signing up TO PARTICIPATE.
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Gender:
Gender:
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This should be the gender of the athlete, unified partner or volunteer that is signing up TO PARTICIPATE.
Male
Female
Prefer not to say
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Email Address:
Email Address:
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This is the address that we will use to share program information. Please update if this is DIFFERENT from the one you entered above.
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Preferred Phone Number:
Preferred Phone Number:
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This is the number we will use for all program communication.
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Date of Birth
Date of Birth
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This should be the DATE OF BIRTH for the athlete, unified partner or volunteer that is signing up TO PARTICIPATE.
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County where you live:
County where you live:
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This should be the county where the athlete, unified partner or volunteer that is signing up TO PARTICIPATE resides.
1.
Lackawanna
2.
Luzerne
3.
Pike
4.
Susquehanna
5.
Wayne
6.
Wyoming
7.
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Are you interested in
participating in Unified Sports? Unified Sports brings individuals WITH and
WITHOUT intellectual disabilities together to train and compete on the SAME team.
Are you interested in
participating in Unified Sports? Unified Sports brings individuals WITH and
WITHOUT intellectual disabilities together to train and compete on the SAME team.
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'If a site below has an "* next to it, there is a possibility for Unified Sports at this site.
Yes
No
Maybe
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I would like to sign up for SPORT at the following location:
I would like to sign up for SPORT at the following location:
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Luzerne County, TBA*
Other…
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This form is being filled out to sign up as:
This form is being filled out to sign up as:
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Athlete: Special Olympics athletes are eight years old or older and have an intellectual disability, a cognitive delay, or a developmental disability. Athletes who are 6 and 7 years old are able to train in a sport but not compete.
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Head Coach: Create, organize, and lead a comprehensive sport training program for a team of athletes and volunteers.
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Assistant Coach: Help to organize practice and assist athletes in acquiring sport skills.
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General/Sport Volunteer: Volunteer who only has limited contact with athletes or who have contact with athletes accompanied by coaches.
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Unified Partner: Volunteer (8 year old and older) who trains and competes alongside an athlete.
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Section 2 of 3
Athlete/Unified Partner: TELL US MORE ABOUT YOURSELF
Please make sure to use your full official name when filling out this section.
Who does the email address belong to that was submitted above?
Who does the email address belong to that was submitted above?
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Athlete/Unified Partner
Parent/Guardian/Caregiver
Support Staff
Coach
Other
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Are you a NEW or returning Athlete OR Unified Partner?
Are you a NEW or returning Athlete OR Unified Partner?
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NEW = I have NEVER participated in Special Olympics PA sports before. PRIOR TO STARTING, NEW ATHLETES ARE REQUIRED TO COMPLETE AND SUBMIT AN ATHLETE MEDICAL. You can find a link to the SOPA medical in the confirmation email you will receive after submitting this form.
RETURNING = I have participated in Special Olympics PA sports. Athletes must have current medical on file with SOPA in order to participate. You can find a link to the SOPA medical in the confirmation email you will receive after submitting this form.
I am Unified Champion School ATHLETE (Unified Bocce or Track & Field)
I am Unified Champion School UNIFIED PARTNER (Unified Bocce or Track & Field)
I DON'T KNOW
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Parent/Caregiver/Support Staff's First and Last Name
Parent/Caregiver/Support Staff's First and Last Name
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Parent/Caregiver/Support Staff's Home or Cell Phone #
Parent/Caregiver/Support Staff's Home or Cell Phone #
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Parent/Caregiver/Support Staff's email address
Parent/Caregiver/Support Staff's email address
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Section 3 of 3
Volunteer: TELL US MORE ABOUT YOURSELF
Please make sure to use your full official name when filling out this section.
Are you a NEW or returning volunteer?
Are you a NEW or returning volunteer?
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NEW = you have never participated in Special Olympics PA sports. PRIOR TO VOLUNTEERING, ALL VOLUNTEERS MUST COMPLETE A VOLUNTEER APPLICATION found on the “Become a Volunteer” webpage on the Special Olympics Pennsylvania website.
RETURNING = you have previously participated in Special Olympics PA sports. Prior to participating volunteers must have met all volunteer requirements: Current Background Check, Protective Behaviors & Concussion Protocols as well as completing General Orientation. You can check your eligibility status by going to the “Become a Volunteer” webpage on the Special Olympics Pennsylvania website.
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Are you a CERTIFIED coach in THIS sport?
Are you a CERTIFIED coach in THIS sport?
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Yes
No
Not yet, but I would like to be.
Not sure.
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