U.S. Member of Inas International Federation for Athletes with Intellectual Disability (202) 544-0510 TEL (202) 544-0510 FAX www.athleteswithoutlimits.org WELCOME Dear Athletes, Families & Coaches, Athletes Without Limits is excited to offer you the opportunity to compete among the top athletes with intellectual disability in the World, in open competition in mainstream sport, and new opportunities in the Paralympics. The international federation for para-athletes with intellectual disability (Inas), has been hosting high-level competition for over two decades in Athletics (Track & Field), Basketball, Cycling, Judo, Rowing, Soccer/Futsal, Skiing, Swimming, Tae Kwon Do, Table Tennis, and Tennis. As the US Member of Inas, Athletes WIthout Limits organizes US Teams and travel to these events, as well as the athlete eligibility process. We also help athletes find opportunities to train and compete in the US, including new opportunities in Paralympic Athletics, Swimming & Table Tennis, which added events for athletes with intellectual disability between 2010 and 2012. The first step in helping US athletes get involved is to determine eligibility for Inas and Paralympic sport using the attached application. It is important to note that because an athlete may prove ineligible for Inas/Paralympic competition, that does not necessarily mean he/she will not be eligible for other disability programs. Competing in Inas/Paralympic events is just one of many opportunities available—we support and encourage all aspiring athletes with intellectual disability to train and compete in mainstream sport and look forward to working with you toward achieving your athletic dreams! Please do not hesitate to contact us at 202-544-0510 or info@athleteswithoutlimits.org with any questions. Sincerely, Julie & Barry Holman Athletes Without Limits Co-Founders Revised: Dec 22, 2015 Eligibility Overview ELIGIBILITY CRITERIA Inas is the International Federation for para-athletes with intellectual disability and a member of the International Paralympic Committee. Together the two organizations established the eligibility criteria below. To be eligible athletes must meet all of the three criteria: ✓ INTELLECTUAL FUNCTIONING (IQ) AT OR BELOW 75 ✓ SIGNIFICANT LIMITATIONS IN ADAPTIVE BEHAVIOR ✓ DISABILITY ONSET BEFORE AGE 18 STEP 1: NATIONAL ELIGIBILITY For most athletes national eligibility will be an appropriate starting point that will allow entry into US and some Inas developmental events. To apply athletes should complete all sections (A-F) of the enclosed athlete application. For Section B Evidence, just send whatever past school, psychological or disability assessments that are readily available to you. Our US psychologist will review the materials to determine likelihood of eligibility. STEP 2: INTERNATIONAL ELIGIBILITY Athletes whose performance times are competitive at the international level will be encouraged to complete the full Inas eligibility process. Eligibility at this level requires more specific medical documentation that may not already be in an athlete’s school or other records. Sometimes new psychological assessments are needed. Once an athlete has the specific evidence listed in Section B International, we will submit the application to Inas for review by the International Eligibility Committee. MEDICATIONS & DRUG TESTING Just like the Olympics, random drug testing is enforced at Inas and Paralympic events. Athletes who take medications that are on the banned substance list of the World Anti-Doping Agency (WADA) may need to apply for a Therapeutic Use Exemption (TUE). We will look up the names of medications you provide in this application and let you know what is needed. PARALYMPIC SPORT-SPECIFIC CLASSIFICATION (APPLIES ONLY TO TRACK & FIELD, SWIMMING & TABLE TENNIS) After an athlete completes International eligibility and is added to the Inas Master List, there may be a sport-specific classification process managed by the sport’s International governing body. For athletes with intellectual impairment, this involves athlete interviews and observation while competing at Inas or Paralympic events. Athletes Without Limits will provide more information on what, if any, sport-specific testing will be involved on a case-by-case basis. USE OF INFORMATION Athletes Without Limits will not share athlete information beyond the U.S. and Inas Eligibility Committees, comprised of psychologists and their administrators, without consent. Medication exemption applications (TUEs) will be submitted to the U.S. Anti-Doping Agency (USADA) and Inas medical officer for approval. Inas will use the information submitted within the application for the purpose of determining eligibility to compete as an athlete with an intellectual disability or for conducting related procedures such as protests and appeals. It may share information with relevant partners, including the IPC, for these purposes. For more details on the Inas Data Protection and Information Handling policy, visit: www.inas.org. Eligibility Checklist Use the instructions below as a checklist to make sure your Application is complete. A. INAS ATHLETE APPLICATION Inas Eligibility Athlete Application: Parents/guardians and athletes should complete and sign pages 1-2. B. EVIDENCE OF INTELLECTUAL DISABILITY National Level Eligibility: Copy of readily available past school/psychological/social security or disability assessments. To get started with eligibility send whatever information you have on hand. This will allow us to determine if the athlete is likely eligible before tracking down the full international requirements below. International Level Eligibility: In order to for an athlete to compete internationally Inas requires the exact documentation below. Note: Some athletes may require new psychological testing to meet the requirements below: Copy of a Weschler Family (WAIS, WISC, etc.), Stanford Binet or Raven Matrice IQ assessment given within the last 5 years that demonstrates Full Scale IQ of 75 or below. Report must include narrative report and a copy of the summary score sheets. (Note: WASI short form will not satisfy the Inas IQ requirement). Copy of an Adaptive Behavior assessment, most common are Vineland, ABAS or AAMR, given within the last 5 years. Include psychologist’s narrative report and a copy of the summary score sheets. Proof of Age of Onset prior to 18: Can be a copy of or mention of an IQ score achieved before age 18 or a psychologist’s statement explaining evidence on which a diagnosis of intellectual disability before age 18 is based. C. RELEASE FORMS Athletes Without Limits Liability & Photo Release Form (Athlete & Parent) D. CONTACT, MEDICATION & EMERGENCY MEDICAL FORM Athletes Without Limits Emergency Medical Form. (It is important to include medications so we can confirm that all are allowed in competition by the World Anti-Doping Agency WADA.) E. COACH’S SURVEY (TSAL) Copy of completed Coach’s Survey (TSAL) Note that while the survey is not a part of the eligibility check, it is required by Inas as part of a research tool used to inform and develop the system of athlete classification. Can be completed by the parent/ guardian if the athlete does not have a coach. F. OTHER ATTACHMENTS Athletes’s headshot submitted as jpg, these do not need to be professionally taken. A copy of the athletes passport. If the athlete needs to apply for a Passport, a copy of a birth certificate or state I.D. can be used until passport arrives. $50 application fee paid online at: www.athleteswithoutlimits.org/payments SUBMITTING THE APPLICATION Please email or fax all forms and make payment for the $50 application fee at www.athleteswithoutlimits.org/payments Email: info@athleteswithoutlimits.org Phone/Fax: 202-544-0510 We are unable to accept athlete applications by snail mail. A. Athlete Application Please email digital photo to: info@athleteswithout limits.org 1 of 2 USA A. Athlete Application Written consent from athlete/parent/guardian required for release information for US athletes. 2 of 2 B. Evidence of Disability National Level: To get started with eligibility send any reports you have on hand from past school, psychologist, or disability assessments. This will allow us to determine if the athlete is likely eligible before assembling the full international requirements below. International Level: In order to for an athlete to compete internationally Inas requires the exact documentation below. Some athletes may require new psychological testing. 1) INTELLECTUAL FUNCTIONING (IQ SCORE) OF 75 OR LOWER Significant impairment in intellectual functioning is defined as a Full Scale IQ score of 75 or lower. Diagnosis must be made using the latest version of an Inas recognized IQ test (full version) given within the last 5 years by a licensed professional. Recognized IQ Tests: 1) Wechsler Intelligence Scales 2) Stanford-Binet or 3)Raven Matrices (Weschler includes WISC for children; WAIS for adults; HAWIE; SSAIS, MAWIE etc; WASI short form is NOT accepted) What to send us: A copy of psychologist’s assessment summary report on formal letterhead that includes a detailed narrative commentary/assessment of each sub-test area. and official summary score sheet. If no summary score sheet is available, a list of scores can be typed into the report as long as it includes all Sub-Test Scores and Full Scale IQ. 2) SIGNIFICANT LIMITATIONS IN ADAPTIVE BEHAVIOR Significant limitations in adaptive behavior as expressed in conceptual, social, and practical adaptive skills is defined as performance that is at least 2 standard deviations below the mean of, either: i) One of the following 3 types of adaptive behavior: conceptual, social, or practical skills, OR ii) An overall score on a standardised measure of conceptual, social and practical skills. Diagnosis must be made using an internationally recognised and professionally administered standardised measure given within the last 5 years. Recognized Adaptive Behavior Tests: Vineland, ABAS or AAMR Adaptive Behaviour Scales. Other assessments with a standardised measure that has been norm-referenced on the general population, including people with disabilities may be accepted. What to send us: A copy of psychologist’s assessment summary report on formal letterhead that includes a detailed narrative summary under each domain including: communication, self-care, self-direction, social/interpersonal skills, and ability to respond to life changes and environmental demand. A clear summary/final diagnosis stating clearly whether the person has significant limitations in Adaptive Behaviour and a copy of the official summary score sheet. If no summary score sheet is available, a list summarizing scores in each domain may be typed into the report. 3) AGE OF DISABILITY ONSET UNDER 18 Intellectual disability must be evident during the developmental period—from conception to 18 years old. What to send us: A copy of an official IQ Test or reference to an IQ score from before the age of 18 OR a signed declaration from current psychologist stating clearly the evidence on which the diagnosis is based. Note: If an athlete will be getting new testing for the purposes of Inas eligibility, please refer your psychologists to download Resources for Psychologists from: www.athleteswithoutlimits.org/downloads/psychologists.pdf C. Release Forms Note: Each athlete, parent/guardian, sibling and coach who will be traveling with the athlete should sign. Liability Release (required for participation) (Name) _____________________________________ would like to travel with and/or participate in group trips or programs with Athletes Without Limits. I acknowledge the risks and potential for risks of travel and participating in various sports. However, I feel that the possible benefits to myself/my son/my daughter/my ward are greater than the risk assumed. I hereby intend to be legally bound, for myself, my heirs and assigns, executors or administrators, waive and release forever all claims for damages against Athletes Without Limits, its Board of Directors, Coaches, Aids, Volunteers and/or Employees for any and all injuries and/or losses I/my son/my daughter/ my ward may sustain while traveling with Athletes Without Limits or while participating in, planning, or attending sporting, training and other events as part of Athletes Without Limits programming. Athlete Signature: Date: Parent/Guardian 1 Signature: Date: Parent/Guardian 2 Signature: Date: Coach Signature Date: Sibling/Other Signature Date: Photo/Film/Bio Release (optional): I hereby consent to and authorize the use and reproduction by Athletes Without Limits (and its media partners) of any and all photographs and other audiovisual materials (including film) taken of me/my son/my daughter/my ward for promotional, educational fundraising and any other use for the benefit of Athletes Without Limits and its mission and programs. Examples include an athlete photo and bio that will appear on athleteswithoutlimits.org website, press releases, Facebook and Twitter updates, fundraising materials, etc. Athlete Signature: Date: Parent/Guardian 1 Signature: Date: Parent/Guardian 2 Signature: Date: Coach Signature Date: Sibling/Other Signature Date: D. ConTaCT & Emergency Medical Notes CONTACT INFORMATION Name of Person Completing Application: Relation to Athlete: Phone: Email: Athlete’s Nickname: Athlete’s Legal Name Athlete’s Address: Athlete’s Home Phone: *Athlete’s Date of Birth MEDICAtIONS List Name and Dose so we can make sure none are banned in competition: Medication Name: Dose: Frequency: Medication Name: Dose: Frequency: Medication Name: Dose: Frequency: MEDICAL NOTES Allergies: Date of last tetanus shot: Atlanto Axial Instability (AAI): ❑ Symptomatic AAI ❑ Asymptomatic AAI ❑ Clear Sickle Cell Disease: ❑ YES ❑ NO (problematic when events take place at high altitude) Other important medical notes: MEDICAL INSURANCE Insurance company: Insurance company phone: Policy #: Relationship: Name of primary insured: Physician name and phone: Supplemental trip insurance provider if any: EMERGENCY CONTACT Name: Home phone: Email: Work phone: Cell phone: E. Other Attachments Please include the following with your application: 1. HEADSHOT Inas requires a jpg of each athletes’s headshot. If you don’t have one, we can crop a snapshot for you. Note that these do not need to be professionally taken. 2. PROOF OF IDENTITY (PASSPORT) Inas and Paralympics require a copy of the athletes passport as proof of identity. Please scan/photocopy the main page of the athletes passport and include it with your application. If the athlete needs to apply for a Passport, a copy of a birth certificate or state I.D. can be used until passport arrives. 3. APPLICATION FEE There is a $50 application fee for processing full eligibility. Please make this payment online at: www.athleteswithoutlimits.org/payments F. Coach’s Survey Note that there are different versions of the Coaches Survey for different sports. Download the correct version for your sport at http://www.athleteswithoutlimits.org/eligibility INTRODUCTION SUBMITTING THE TSAL The Training History & Sport Limitations Inventory (TSAL or “Coach’s Survey”) is a research tool used by Inas to inform and develop the system of athlete classification. Ideally the TSAL should be submitted along with the athlete's full eligibility application. If that is not possible, the athletes’s coach can send the TSAL directly to Athletes Without Limits by Fax or Email. Remember to keep an original copy of all documents for your home records. While it does not affect an athlete’s eligibility status, Inas requires it to be included with the athlete’s eligibility application. The survey should be completed by the athlete’s personal/primary coach; all questions must be answered by checking the appropriate box. Phone: 202-544-0510 Fax: 844-544-0510 Email: info@athleteswithoutlimits.org