2022 USA Games TeamSport Athlete/PartnerNomination Team Louisiana

2022 USA Games TeamSport Athlete/PartnerNomination Team Louisiana
Name *

First Name Last Name
Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Date of Birth: *

Month Day Year
Date
Phone Number: *
Cell Phone *

Area Code Phone Number
T Shirt *
Email address: *
example@example.com
Gender: *

[ ] Male [ ] Female
Parent/Legal Guardian Name (required for all Partners under 18 and ALL athletes) *

First Name Last Name
Parent/Legal Guardian Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Parent/Guardian Phone Number: *
Parent/Guardian Cell Phone: *
Team Sport Athletes and Partners
Sport Teams must be nominated as an already-existing team (CANNOT be nominated as individual athletes You will need to fill out and submit all of above information for EVERY athlete/Unified Partner on your team. Be sure to enter the same TEAM NAME on each of the nominations you submit. Teams must have received a gold medal at a state competition in the sport for which you are applying in either 2018, 2019 or 2020.
Team Name (be specific, ie Bayou Blue Falcons): *
Year of your gold medal: *

[ ] 2018 [ ] 2019 [ ] 2020
Select your individual sport *

[ ] Unified Basketball (Male) [ ] Unified Softball [ ] Unified Flag Football [ ] Unified Volleyball
Has this athlete ever attended a USA Games or World Games? *

[ ] Yes [ ] No
If yes, what year?
If yes, what sport did you participate in?
How many years has the athlete participated in Special Olympics Louisiana? *
Other SOLA sports participated in? *
Hobbies/hidden talent? *
Who is your hero/idol and why? *
Where do you go to school (or work)? *
If you have a job, what kind of work do you do?
Favorite moment at a SOLA event: *
Why do you want to go to USA Games? *
Are you able to commit to the 12-months of training leading up to USA Games? *

Yes No
Are you able to fundraise the required $500 to be a part of the Team Louisiana delegation for the 2022 USA Games? *

[ ] Yes [ ] No
Name of our local coach for the sport for which you are applying:
Name *

First name Last Name
Local Coach Phone: *
Comments:
Upload a photo of yourself *

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I have read and understand the job description and general expectations of the position and the information I have given SOLA is true and complete. I understand that I will need to attend all meetings, trainings, the mini-camp and conference calls. I understand that I will need to raise a minimum of $500 to cover my expenses. I understand the SOLA staff may remove me from the delegation if I fail to meet the requirements of the job description or act outside the Code of Conduct.
Signature *

Clear
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2022 USA Games TeamSport Athlete/PartnerNomination Team Louisiana

Team Sport Athletes and Partners