Dream Camp 2023 Counselor Application
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First Name *
Last Name *
Cell Phone Number *
Street Address: *
City: *
State: *
Zip Code: *
Email: *
D.O.B. *
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Disability: *
If "other" disability, please list type:
Special accommodations/needs (include dietary restrictions): *
Gender *
Race
Clear selection
Sport/s currently participating in: *
Required
How did you hear about Dream Camp? *
Do you have any of the following certifications?
Have you ever been a camp counselor? *
If yes, which camp(s) and when?
Please complete a short essay and tell us why you would like to be a 2023 Dream Camp Counselor: *
Please tell us about any previous experience you have working with children with disabilities? *
ADAPTIVE SPORTS OHIO PARTICIPANT EXPECTATIONS *
FURTHERMORE, ATHLETES WHO PARTICIPATE IN ADAPTIVE SPORTS OHIO'S PROGRAMS:  Will understand and respect the differences between athlete roles and coaching roles and will refrain from coaching other players during games and practices.  Uphold the authority of Adaptive Sports Ohio staff, coaches and officials who are working with you. Assist them when possible and use good judgment if you disagree with them. Will be a positive role model by respecting Adaptive Sports Ohio staff, officials and their authority during games and will never question, discuss or confront coaches before, during, or immediately after a contest.  Will take time to speak to coaches and Adaptive Sports Ohio staff at an agreed upon time and place.  Keep negative comments to yourself. Express concerns only to the coach and in a straightforward, fair, and objective manner. Will try your best to make athletics a positive experience for everyone involved. Will treat other players, coaches, Adaptive Sports Ohio staff, officials, and spectators with respect regardless of race, creed, color, sex or ability. Will promote the emotional and physical well-being of all athletes ahead of any personal desire you may have to win. Will not encourage any behaviors or practices that would endanger the health and well-being of participants. Will be a positive role model and encourage sportsmanship by showing respect and courtesy, and by demonstrating positive support for all players' coaches, officials, Adaptive Sports Ohio staff and spectators at every game, practice or sporting event. Will not engage in any kind of unsportsmanlike conduct with any Adaptive Sports Ohio staff, official, coach, player, or parent such as booing and taunting; refusing to shake hands; or using profane language or gestures. Will remember that your participation in an Adaptive Sports Ohio athletic event is a privilege and not a right. Will follow Adaptive Sports Ohio’s drug and alcohol free policies and refrain from use of alcohol and other drugs before or during contests. Will uphold Adaptive Sports Ohio policies included in the handbook.
Required
ADAPTIVE SPORTS OHIO CODE OF CONDUCT *
Adaptive Sports Ohio, a non-profit organization, provides quality competitive and non-competitive sports and recreation, which includes establishing a high standard of athlete behavior, and ensuring the safety and well-being of all athletes involved in training and competition. All athletes and participants are expected to abide by the following Athlete Code of Conduct.  ATHLETE STANDARDS OF BEHAVIOR The following behavior is unacceptable while participating in any Adaptive Sports Ohio's event, including but not limited to training, program sessions or competitions, transportation to and from practice/sessions, competitions, and any Adaptive Sports Ohio organized event:   Profanity or verbal abuse; Tobacco use in restricted areas;  Use of Alcohol in violation of Adaptive Sports Ohio’s Alcohol Policy, Physical or verbal sexual overtures; Physical abuse; Use of illegal drugs or any unauthorized use of controlled substance; Poor sportsmanship; Violent or disruptive behavior; Any unwelcomed physical contact; Possession of harmful weapons; Behavior, including, but not limited to, harassment, bullying, degrading, intimidating, etc., another participant, staff, spectator, competitor, volunteer or referee in any manner, including, but not limited to, in person, via social media, via electronic communication, via written form etc., which disrupts, impedes or reflects poorly on Adaptive Sports Ohio.  GUIDELINES FOR LIMITING OR DENYING AN ATHLETE INVOLVEMENT: 1) Admission or adjudication of involvement in abuse, neglect, sexual assault or conduct involving violence or threat of violence, 2) Record of being charged with abuse, neglect, conduct involving violence or threat of violence, or sexual assault with corroborating information, 3) Violation of the Code of Conduct, or 4) Use, possession or distribution of illegal drugs.  Adaptive Sports Ohio’s President/CEO and/or Board of Directors will address each situation on a case-by-case basis following the above guidelines.  Adaptive Sports Ohio requires that all athletes understand and sign the code of conduct before participating in Adaptive Sports Ohio's related events and programs.
Required
CONSENT TO PHOTOGRAPH *
Adaptive Sports Ohio is hereby given permission for photographing, recording, and/or illustrating of an individual for release to the news media, promotional, and/or recruiting purposes.
Required
Adaptive Sports Ohio Waiver, Release of Liability, and Consent for Medical Treatment: *
In exchange for my being allowed to participate in the Adaptive Sports Ohio's activities, programs and/or events, I and if I am not yet 18 years old, my parent or legal guardian, agree to be bound by each of the following: 1. Assumption of Risks: I assume all risks connected with my participation in Adaptive Sports Ohio's activities, programs and/or events. I accept personal responsibility for any liability, injury, loss, or damage in any way connected with my participation in Adaptive Sports Ohio's activities, programs and/or events. 2. Waiver and Release: I release and discharge Adaptive Sports Ohio and each of their directors, officers, sponsors, agents, and assigns from all claims for any liability, injury, loss or damage in any way connected with my participation in Adaptive Sports Ohio’s activities, programs and/or events.. I intend for this waiver and release to also apply to my relatives, personal representatives, heirs, beneficiaries, next of kin, and assigns who might pursue any legal action or claim for such liability, injury, loss or damage. 3. Consent for Medical Treatment: I agree that Adaptive Sports Ohio may, but have no duty to provide me, through medical personnel of their choice, medical assistance, transportation, and emergency medical services. I have read this Waiver, Release, and Consent and understand and agree to the terms and conditions contained herein. I am signing this Waiver, Release, and Consent voluntarily.
Required
Adaptive Sports Ohio Waiver and Release of Liability and Assumption of Risk:
I am aware and understand that there are certain risks associated with my participation in Adaptive Sports Ohio’s activities, programs, and events, including but not limited to risk of injury, loss, death, and property damage. I also acknowledge that any injuries, loss, death, or damage I sustain could be compounded by negligent emergency response or rescue operations of Adaptive Sports Ohio. I acknowledge that I am knowingly and voluntarily participating in Adaptive Sports Ohio’s activities, programs, and events with an express understanding of the danger involved and hereby agree to accept and assume any and all risks of injury, loss, death, or property damage, whether caused by or that may result from the negligence of Adaptive Sports Ohio, Adaptive Sports Ohio’s directors, officers, sponsors, employees, other agents, and assigns, or any other participant in Adaptive Sports Ohio’s activities, programs, or events, to the fullest extent permitted by law.  Assumption of Risks from Communicable Diseases, Including COVID-19:  I am aware and understand that one of the risks associated with my participation in Adaptive Sports Ohio’s activities, programs, and events is the risk of direct or indirect contact with individuals who have been exposed to and/or diagnosed with one or more communicable diseases, including but not limited to COVID-19 or other medical conditions, diseases, or maladies, and/or any mutation or variation thereof. I am aware and understand that such risk exists and that it is impossible to eliminate the risk that I could become infected through contact with or close proximity to an individual with a communicable disease, and that such infection could result in injury, loss, death, or other damage. I knowingly and freely assume all such risks, both known and unknown, including those arising from the negligence of Adaptive Sports Ohio, its agents, and other participants in Adaptive Sports Ohio’s activities, programs, or events, and I assume full responsibility for my participation. Additionally, I willingly agree to comply with the stated and customary terms and conditions for participation in Adaptive Sports Ohio's activities, programs, and events, and I acknowledge that I have received and reviewed Adaptive Sports Ohio’s “Return to Play” Policy and agree to comply with its terms.
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