pg 1Are you NEW or RETURNING to Special Olympics Delaware NEW RETURNINGEmailEmailName of Employer Optional Athlete Employer OptionalCellCellSODE ATHLETEMEDICAL FORM HEALTH HISTORYPages 1 ID: 873765
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1 pg. 1 Area/School Name: ________________
pg. 1 Area/School Name: _______________________________________________________________________________ Are you NEW or RETURNING to Spec
2 ial Olympics Delaware? NEW
ial Olympics Delaware? NEW RETURNING Email: Email: Name of Employer (Optional): Athlete Employer (Optional): Cell:
3 Cell: SODE ATHLETE MEDICAL FORM - HEALTH
Cell: SODE ATHLETE MEDICAL FORM - HEALTH HISTORY (Pages 1-5 should be completed by the athlete or parent/guardian/caregiver) www.sode.
4 org Please mail or scan completed forms
org Please mail or scan completed forms to: Special Olympics Delaware - 619 S. College Ave., Newark DE. 19716 / info@sode.org pg. 2 SODE
5 ATHLETE MEDICAL FORM - HEALTH HISTORY (
ATHLETE MEDICAL FORM - HEALTH HISTORY (Pages 1-5 should be completed by the athlete or parent/guardian/caregiver) (List on page 3) If
6 yes, please describe: pg. 3 SODE ATHLET
yes, please describe: pg. 3 SODE ATHLETE MEDICAL FORM - HEALTH HISTORY (Pages 1-5 should be completed by the athlete or parent/guardi
7 an/caregiver) pg. 4 Release Form SODE AT
an/caregiver) pg. 4 Release Form SODE ATHLETE RELEASE & WAIVER (Pages 1-5 should be completed by the athlete or parent/guardian/caregi