PARTICIPATION WAIVER AND PROMOTIONAL MEDIA OPT-OUT FORM

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SPECIAL OLYMPICS ALBERTA
the “Organization”

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What this form is

This form is the agreement between you and Special Olympics needed when you participate
in Special Olympics programs and activities as an athlete or volunteer. It contains:

1. Important terms to ensure the safety and well-being of all participants, and to protect
Special Olympics.
2. The opportunity for you to opt out of allowing Special Olympics to use promotional
media.

In this document, “Special Olympics” refers to Special Olympics Canada, to the provincial and
territorial chapters of Special Olympics in Canada, to Special Olympics International, and to all
the agents, employees, and volunteers of each of these organizations.

Please check the appropriate box, and WRITE THE FULL NAME OF THE PARTICIPANT WHO IS REGISTERING IN THE 'OTHER' AREA - after choosing your option. * *

I ____________ (Name typed in "other" section) am the age of majority in my province or territory. I am registering as a Special Olympics ATHLETE and signing this waiver on my own behalf.

I ____________ (Name typed in "other" section) am the age of majority in my province or territory. I am registering as a Special Olympics VOLUNTEER and signing on my own behalf.

I am the PARENT OR LEGAL GUARDIAN of ____________ (Name typed in "other" section), a person who is under the age of majority who is not capable of giving legal consent on their own. I am signing this waiver on behalf of the person named in the other box below.

Otro:

Obligatorio

What you need to do before you sign this form

Before you sign this form, please carefully read all of the following terms and conditions. If
you have any questions about what any of the terms and conditions mean, please ask the Special Olympics Alberta staff at info@specialolympics.ab.ca or call 1-800-444-2883.

This form must be completed and signed by a person who has legal capacity to consent, or by
the parent or guardian of a person under the age of majority or who otherwise does not have
the capacity to provide legal consent on their own.

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