Virtus Eligibility Application for Project Inspire Soccer League

Welcome Project Inspire Soccer Teams!

This version of our online application is for US soccer players seeking eligibility confirmation for Project Inspire. Athletes Without Limits has enjoyed helping athletes navigate this process since we launched in 2009. Lifetime Virtus eligibility opens the door to competing not just in Project Inspire, but also many other sports offered by Athletes Without Limits, Virtus International or even Paralympics!

APPLICATION FEE WAIVED
The Inspire League is covering your application fee!

WHO'S ELIGIBLE FOR PROJECT INSPIRE?
Athletes in any of the three Virtus Intellectual Impairment "II" Eligibility Groups:

II1-Intellectual Disability (includes Autism w/Intellectual Disability)
II2-Down Syndrome (Trisomy 21 and Translocation)
II3-Autism

THINGS YOU'LL NEED HANDY TO UPLOAD:
1. PLAYER's HEADSHOT
2. PLAYER's US PASSPORT (or State ID or Birth Certificate)
3. EVIDENCE OF DISABILITY:
- Players with Down Syndrome:
  a) Cytogenetic blood test report from birth. If that report is not available a doctor note/medical record that shows TYPE of Down syndrome (Trisomy21, Translocation or Mosaic) will be accepted for Project Inspire National.
  b) Previous neck x-ray for AAI safety.
  c) After you apply you'll receive a link to our Doctor AAI Clearance Form which your doctor can Esign.
- Players with Intellectual Disability:
  a) Latest School IEP and most recent psychological reports with IQ scores & Adaptive Behavior results like Vineland or ABAS.
- Players with Autism:
  a) Latest School IEP and most recent psychological reports with IQ scores & Adaptive Behavior results like Vineland or ABAS.
  b) Include any report(s) where Autism diagnostic assessments were used like ADOS, CARS, GARS etc.
We'll let each player know if additional or new assessments will be needed to confirm National Project Inspire League eligibility or full International Virtus Event Eligibility. For a more detailed explanation of National & International eligibility documentation requirements see our SOCCER ELIGIBILITY FAQ page.

ELIGIBILITY QUESTIONS
We've tried to make our application and questions self-explanatory, but if you have any trouble please CONTACT US to reach out.

PART 1 of 6: APPLICATION CONTACT
Who is submitting this application?*

I'm a player filling out my own application.MotherFatherGuardianCoach or Team ManagerOther
Name of Person Completing the Application*

First NameLast Name
Email for Person Completing the Application (for email confirmation) *
We gather several contacts in this application, which is the best email address to receive confirmation and application updates once you click submit?
Cell phone of Person Completing the Application*
Please enter your phone number in case we have any questions about the application.
Have you already filled out our previous PDF Application ?

No, I'm just getting startedYes, I've filled out the PDF version.
Got it! You can upload your completed PDF Application below:

Please continue through the rest of this application to submit your Passport/ID, headshot and evidence of disability. We also really appreciate you re-entering other information that may already be on your PDF Form as we transition to this online format — our goal is to make easier for athletes to apply and quicker for us to review them!
UPLOAD COMPLETED PDF VERSION OF THE APPLICATION

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PART 2 of 6: ATHLETE INFORMATION
Athlete Legal Name (as stated on Passport or ID)*

First NameMiddle NameLast Name
Athlete Preferred Name or Nickname
What name do you preferred to be called?
Main sport for which Virtus Eligibility is Needed:*
{mainSport} Team Name:*
Other sports the athlete regularly trains for and competes in (optional):
So we can share other possible opportunities!
Athlete Full Name (in Single Field)
Todays Date

MonthDayYear
Date
Athlete Date of Birth*

MonthDayYear
Athlete Legal Gender (as stated on Passport or ID)*

MaleFemaleOther
Athlete Date of Birth in DD/MM/YYYY

DayMonthYear
Date
Athlete Age
Athlete Phone
Please enter a valid phone number.
Athlete Email
example@example.com
Athlete Address*

Street Address

Street Address Line 2

CityState

Zip Code
Athlete Address (Single Line)
Does the athlete already have their US Passport?*

Yes - Please upload a legible copy or photo of main page belowNot yet - Please upload US State ID, License or Birth Certificate belowOther
VIRTUS MEMBERS FOR OTHER COUNTRIES
As the USA Member of Virtus, Athletes Without Limits is only able to manage applications for athletes who have (or can apply for) a US Passport. Athletes from other countries can check the Virtus website to contact their member.
Passport Number
Passport Expiration Date

MonthDayYear
UPLOAD PASSPORT*

Scan or take a photo of the main page.
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UPLOAD PHOTO ID or BIRTH CERT. *

Only needed if athlete does not have a Passport
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UPLOAD ATHLETE HEADSHOT*

If you don't have a headshot send a nice photo that shows your face and we will crop it : )
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PART 4 of 6: EMERGENCY MEDICAL
Dietary Preferences & Food Allergies or Restrictions*

VeganVegetarianGluten FreePeanut AllergyTree Nut AllergyNo Food AllergiesOther
Dietary Summary
Other Allergies?
Seasonal Hayfever, Allergies to Medications?
Other Important Medical Notes
Does the athlete have ASTHMA, SEIZURES, SICKLE CELL or other important medical notes?
ANTI-DOPING & DRUG TESTING

Both Virtus and Paralypmics follow the same anti-doping rules as the Olympics. This means athletes competing at Virtus World Championships, U.S. Paralympics or other events may be randomly drug tested while at an event.

Therapeutic Use Exemptions (TUE)
Some medications that athletes with intellecutal impairments need may be considered "banned substances" in which case additional paperwork signed by your doctor is needed. So we can help provide guidance please enter the athlete's medications below.
Does the athlete take any prescription medications?*

No MedicationsYes

PART 5 of 6: PARENT/GUARDIAN INFORMATION
Parent or Guardian Name*

First NameLast Name
Parent or Guardian Name (Single Field)
Relationship to Athlete*
Mother, Father, Guardian, etc.
Parent/Guardian Email*
example@example.com
Parent/Guardian Cell Phone*
Enter Parent or Guardian's Phone Number
Does the parent/guardian have the same address as the Athlete?*

Yes, parent/guardian has same addressNo, parent/guardian has diffferent address
Parent/Guardian Address*

Street Address

Street Address Line 2

CityState

Zip Code
Parent Address (Single Line)

Great work sticking with this application!

Let's double check your email address.
A confimation email will be sent to the addresss below:

{weGather}

If this isn't correct please use the back button
to go back to PART 1: Application Contact and correct it!

If you've added everything you can and are ready to submit to Athletes Without Limits for review click SUBMIT below.
Previous Submission Date for Offline Applications

MonthDayYear
Date
Should be Empty:

Welcome Project Inspire Soccer Teams!

PART 1 of 6: APPLICATION CONTACT

PART 2 of 6: ATHLETE INFORMATION

PART 3 of 6: DIAGNOSES & ASSESSMENTS

UPLOAD SUPPORTING REPORTS (REQUIRED)

PART 4 of 6: EMERGENCY MEDICAL

PART 5 of 6: PARENT/GUARDIAN INFORMATION

PART 6 of 6: RELEASE FORMS & SIGNATURES

	Medication	Dose & Frequency	Used to Treat...
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