Forms, Waivers and Releases necessary for participation
in MASD Sports and Recreation programs are available
by clicking the links below. They are available
in Adobe Acrobat (.PDF) format. If you do not
have an Adobe Acrobat Reader, you may download
a free version from Adobe by clicking here.
"New Exciting Opportunity Available For Anyone"
MESA
ADAPTIVE RANGER PROGRAM
How to Register for Current Special Olympics
Programs:
1.
Click on the Link below and print out the packet.
Fill out the Athlete Registration Form and Sign
the Guardian Responsibility Form.
Summer-Fall
08 - Special Olympics Registration Packet
2.
If you are new to the sports programs, please
click the link below to print the MASD Liability
Waiver Form. Sign and Date the Waiver. If the
participant is a minor and/or has a legal guardian,
both signatures are required.
MASD
Waiver Release Form
3.
If you are a new athlete or have an expired
Arizona Special Olympics Physical, print Front
and Back of the Arizona Special Olympics Medical
Release Form. Please fill out in its entirety.
The Medical Release Forms must be filled out
by a Physician. To see if you have a current
physical, contact Susan Byrne Rossi ( susan.rossi@cityofmesa.org
) or call 480-644-5702.
Arizona
Special Olympics Medical Release Form (Front)
Arizona
Special Olympics Medical Release Form (Back)
4.
Mail or Fax the above listed information to
the City of Mesa Office.
City of Mesa; Attn: Susan Byrne Rossi, 200 S.
Center Street, Building 1, Mesa, AZ 85210
Fax: 480-644-2698
5.
Please make a note of the practice times
and locations and show up for some fun!
How to Register for Current Programs
for People with Physical Disabilities:
1.
Click on the link below and print out the packet.
Fill out the Athlete Registration Form and Sign
the Guardian Responsibility Form.
2008
Summer-Fall Physically Challenged Registration
Packet.
Registration
Waiver Form
Physically
Challenged Fact Sheet
2. If
you are new to the sports programs, please click
the link below to print the MASD Liability Waiver
Form. Sign and Date the Waiver. If the participant
is a minor and/or has a legal guardian, both
signatures are required.
Registration
Waiver Form
3.
Review the athlete’s appropriate Disabled Sports
Organization (see links
page) and complete the appropriate Medical
Physical Form in its entirety. The Medical Physical
Form must be filled out by a Physician. To be
a competitive athlete, each participant must
have a current medical physical each year. The
physicals are good January through December
of each year. To see if you have a current physical,
contact Susan Byrne Rossi
( susan.rossi@cityofmesa.org
) or call 480-644-5702.
Cerebral
Palsy Physical
WSUSA
Physical 1
WSUSA
Physical 2
4.
Mail or Fax the above listed information to
the City of Mesa office.
City of Mesa
Attn: Susan Byrne Rossi
200 S. Center Street, Building 1
Mesa, AZ 85210
Fax Line: 480-644-2698
5.
Please make note of the practice times and locations
and show up for some fun!
