Renaissance City Softball ADA Request Form

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This form is to be used to apply for ADA accommodations for all divisions within the RCSL. Please email info@providencesoftball.net once your request has been submitted. If you have doctors note, please include within the email.

Email *

Name *

Phone Number *

Team Name and Division *

Identify the impairment(s) for which you are requesting accommodation(s) and the expected duration of the impairment(s). Include the date of diagnosis. *

Explain how the impairment(s) affects your ability to participate in softball play in accordance with the rules as prescribed in the current Rules of Play.
*

What specific accommodations are you requesting?
*

Has a physician, vocational rehabilitation specialist or other health professional recommended a specific accommodation? If you have documentation to support your request, please email it to info@providencesoftball.net.
*

Yes

You maybe request to provide additional documentation during the review process. Please provide any additional information pertinent to the review process, that you would like to provide. Type N/A if you have no additional information to provide. *

The Renaissance City Softball League reserves the right to request medical documentation to verify the existence of an ADA covered impairment or impairments, and to appropriately assess the condition, functional limitations and/or request for reasonable accommodation(s).

Once submitted, please email info@providencesoftball.net for confirmation.

● Requests and documentation will be reviewed by the Board

● Approval/declination will be sent to the person completing this form.

YYYY

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