2 0 0 8  Registration Form  
Unified Golf / Softball / Basketball /Soccer

for athletes:
Name: _________________________________ Age:________
Address: _________________________________ Birthdate:___/___/___
City/Zip: _____________________________ Shirt Size:______
Phone#: _________________________________ Sex:   M   or    F
E-mail: _________________________________ Social Security#___________
For Softball, Basketball & Soccer only:
                                                                                   
Uniform Size:  Pants:____________ Shirt:____________
                                                                                  

Disability or Disorder:__________________________________________________________
For Athletes:
YES    or     NO     I are new to Special Olympics and need an Athlete Medical Form.
     
(circle one)             
For Volunteers:
If you are not an athlete and wish to volunteer, check here ____ and supply us with your name, address, phone# and e-mail address.  THANK YOU !!
For Unified Golf, mail this form to:
Mark Staggs
339 Center Park Drive
Florence, KY  41042
For Softball, mail this form to:                    
Tim Wagner
412 West 12th St.
Newport, KY  41071
For Basketball, mail this form to:
Debbie Wagner
822 Linden Avenue
Newport, KY  41071
For Soccer, mail this form to:                    
Mark Staggs
339 Center Park Drive.
Florence, KY 41042