athlete application

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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
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