Special Olympics Howard County
Fall Sports Registration Form
To register for a
sport, complete the information below, the Code of Conduct (on the other side
of this form), and return to the office by the due date listed below for each
sport. Forms not received by the due date will result in the athlete's
ineligibility to participate in that sport this season.
Today's Date_____________
Athlete information:
Name__________________________________
Address________________________________City__________________State___
Zip_____
Phone______________
Birthdate____________ Medical Exp. Date (from envelope
label)__________
Medical exp. date must be valid through 10/25/2008 or
later to be eligible to participate. New medicals must be completed once
every three years. If expired, contact
us ASAP at info@somdhc.org or
410-740-0500 to have a medical form sent.
Athletes cannot practice until we have a valid medical on file.
Medications &
Dosage___________________________________________________________
Behavior
Issues________________________________________________________________
______________________________________________________________________________
Please note that
depending on behaviors, a family member or trained one-to-one may be required
to assist with the athlete during practice.
Parent/Guardian Information: *This is the point of contact regarding registration issues,
practice times, behavior issues, etc…
Name___________________________
Email*___________________________________
House Phone_____________________
Cell Phone_____________________
*Email address is
very important for communication with coordinator and for receiving
newsletters. To be added immediately to the monthly
newsletters, email bobbaker@somdhc.org requesting to be included.
Check the Sport for which you are registering: New to Sport? o Yes o
No
|
√ |
Sport |
Start
Date |
Practice
Times |
Practice
Location |
Form Due
Date |
|
|
Cycling |
7/27/08 |
SU 10:00 –
11:30 |
Lake Elkhorn |
7/20/08 |
|
|
Beginner Golf |
7/31/08 |
TH 6:00-7:00 |
Hobbits Glen GC |
7/24/08 |
|
|
Golf (Levels
2-5) |
7/31/08 |
TH 5:30-7:00 |
Timbers at Troy
GC |
7/24/08 |
|
|
Powerlifting
(min age=16) |
8/7/08 |
TH 7:30-9:00,
SU 1:00 - 2:30 |
Quest Fitness
Ctr |
7/31/08 |
|
|
Tennis |
8/16/08 |
SA 10:00 –
11:30 |
Atholton HS |
8/9/08 |
|
|
Cross Country
Running |
8/23/08 |
W 6:00 – 7:00,
SA 9:00 – 10:00 |
Centennial HS |
8/16/08 |
|
|
Soccer |
8/23/08 |
W 6:00 – 7:30, SA
2:30 – 4:00 |
Homewood Field |
8/16/08 |
|
|
Volleyball (Min
age=14) |
8/25/08 |
M 7:00 – 8:30,
W 7:00 – 8:30 |
Mt Hebron HS |
8/18/08 |
*Parent/guardian/counselor
meetings are held at the first practice
SEND COMPLETED FORMS TO:
SOHC, 8970 ROUTE 108 SUITE A1,
COLUMBIA, MD 21045