2019 Special Olympics Northern California Summer Games Healthy Athletes Pre-Registration and Consent
The Special Olympics Healthy Athletes free health screenings will be offered at this year's Summer Games at UC Davis on Saturday, June 22nd, from Noon-6:00pm at ARC Pavilion. SONC will offer Fit Feet, Special Smiles, Strong Minds, Opening Eyes, Health Promotion and Healthy Hearing!

- Fit Feet is a podiatric screening to evaluate problems of the feet and ankles.
- Special Smiles provides dental examinations, personal oral hygiene instruction, and sport mouth guards as needed to
help prevent dental injuries.
- Strong Minds is a relaxation and anxiety training.
- Opening Eyes provides vision exams and dispenses appropriate eyewear as needed.
- Health Promotion provides tips on how to improve and maintain good health and sports performance.
- Healthy Hearing provides free ear examinations.

In order to help with the registration process at the event, we encourage you to complete the form below prior to Friday, June 21st at Noon. When you arrive at Healthy Athletes to be screened, please let the registration/check-in table know that you registered online and they will find your name and information and give you your Healthy Athletes passport. Complete the passport and turn in at the prize table for a gift!

All information submitted will be kept confidential and only seen by the Competition Director and the Healthy Athletes clinicians.

If, instead of completing the form below, you would like to download, complete and bring a paper consent form with you to the games, please visit http://bit.ly/2019-Healthy-Athletes-Consent.

IMPORTANT: Minor athletes must have their parent or guardian complete this electronic document on their behalf.

First Name of Athlete *
Your answer
Last Name of Athlete *
Your answer
County Participating *
Email Address (of Athlete or Parent/Guardian)
If you would like to receive an automated confirmation of your pre-registration, please provide a valid email address. You can still pre-register without providing an email address.
Your answer
Date of Birth *
MM
/
DD
/
YYYY
Is the Athlete listed above at least 18 years of age? *
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