I, the undersigned coach, volunteer, official, parent, or administrator, hereby request permission to participate in Special
Olympics programs. I agree to abide by Spec
ial Olympics rules, policies, procedures, philosophies, and codes of conduct. I
acknowledge that I will be using facilities and programs at my own risk and I hereby release, discharge, and indemnify Specia
l
Olympics British Columbia Society, Special Olympi
cs Canada Inc., and the directors, officers, volunteers, and staff of these
organizations from all liability for injury to person or damage to property both now and in the future. In participating in S
pecial
Olympics activities, I am specifically granting
permission to use my likeness, voice, and words in television, radio, film,
newspaper, magazine, internet, and other media, and in any form not heretofore described for the purpose of advertising or
communicating the purposes or activities of Special Olymp
ics and in appealing for funds to support such activities. The
information I have provided may be verified and I give permission to the Special Olympics British Columbia Society to make
inquiries of others which may include a background investigation to de
termine my suitability to act as a Special Olympics
volunteer. As a volunteer, I may be dealing with confidential and personal information and I agree that I will keep such
information in the strictest confidence. If I am unable to be consulted in case of
any emergency or necessity, Special Olympics
and its agents are authorized on my behalf and for my account to take such measures and arrange for such medical and hospital
treatment as may be deemed advisable for my health and well
-
being. The relationship b
etween the Special Olympics British
Columbia Society and volunteers is an “at will” arrangement and it may be terminated at any time without cause by either the
volunteer or the Special Olympics British Columbia Society. Any and all references to Special O
lympics include and apply
equally to Special Olympics Inc., Special Olympics Canada Inc., and Special Olympics British Columbia Society. I understand
that misrepresentation or omission of information on my part is cause for refusal or dismissal as a volunt
eer with Special
Olympics. I affirm that I have read the above and that the information I have given is true and complete.
Criminal Record Check and Vulnerable Sector Screening
I understand that I am required to immediately inform the CEO
of Special Oly
mpics BC of any charge or conviction for a
criminal offence and that I may be required to withdraw until such time as my charge is dealt with. Should I be convicted
of a criminal offence, a decision will be made as to my future eligibility as a volunteer
with Special Olympics BC.