[Sportsandrec] FW: Information and Registration for 2010 USABA Goalball National Championships
Christella Garcia
christellablue at gmail.com
Sat Apr 17 00:44:03 UTC 2010
_____
From: United States Association of Blind Athletes [mailto:etap at usaba.org]
Sent: Friday, April 16, 2010 2:04 PM
To: Christella Garcia
Subject: Information and Registration for 2010 USABA Goalball National
Championships
USABA Banner
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2010 USABA Goalball National Championships
For Blind & Visually Impaired Men & Women
Hosted by: Blind Sports Organization
When: Friday-Sunday, June 4-6, 2010.
On Friday, a Coaches’ Meeting will be held at 5:00pm. Opening Ceremonies
will begin at 5:30pm. The first games will begin at 6pm. If you are
flying, we suggest booking your flight home for Monday.
Where: University of Delaware’s Carpenter Sports Building at the
intersection of North College Avenue & Main Street (behind Old College Hall)
Who: Goalball Teams and Pool Players who have participated in at least one
regional tournament in 2010 Goalball season. All athletes and coaches must
be current USABA members and your local chapter or affiliate. Spectators
welcome.
Housing: You must reserve your own room by May 14. BSO has blocked 70
rooms at the Howard Johnson Inn. Please note that breakfast is provided for
guests of the hotel. See attached.
Local Transportation: Upon request, BSO will provide transportation between
the Howard Johnson Inn and the venue and between the HJ Inn & train station.
There will be an additional fee for this service. Please call or e-mail
Heidi or Sandy to discuss by May 10.
Are you coming by plane, train, or automobile? (see attached)
Fees: $65 per person (athletes and coaches) + local transportation (if
applicable)
Please make checks payable to Blind Sports Organization or BSO.
The registration fee helps offset the costs associated with hosting the
event including: facility rental, 3 meals, snacks, equipment, officials, &
championship shirts.
Meals: Lunches on Saturday & Sunday and dinner on Saturday will be
provided.
Note: a space has been provided on the medical form for you to indicate
special dietary requests. We will try to accommodate your needs. Please
mark the registration form where indicated.
To Register: Complete the attached forms; call (302) 836-5784; or copy the
forms from www.blindsports.org or www.usaba.org. We must have individual
medical and waiver forms for every player and coach. Registration deadline
is May 10.
Info. About Blind Sports Organization – Check www.blindsports.org for more!
Blind Sports Organization was founded in 1974 and is a 501(c)(3),
non-profit, community-service organization. Our Chapters promote, provide,
and advocate sports and recreation opportunities for blind and visually
impaired youth and adults. BSO offers beep-baseball, goalball, judo,
walk-run club, bowling, audio darts, and more.
Blind Sports Organization
465 Maplewood Road * Springfield, PA 19064-2901
www.blindsports.org * info at blindsports.org
Phone: (302) 836-5784 * Fax: (302) 836-5084
Co-Directors: Sandy & Heidi White
2010 USABA Goalball National Championships
TEAM REGISTRATION
Please complete one form per team.
Team Name: _____________________________________ Men’s ___Women’s ___
Primary Contact
Name: __________________________________ Phone: ___________________
Address: ___________________________________________________________
____________________________________________________________
E-Mail: ________________________________________________
Note: Please list B1, B2, B3, or B4 under Vision. If any player or coach
has a special dietary request due to diabetes, allergy, religious, or other
reason, please check the line under Diet beside his/her name and complete
the section on his/her medical form.
PLAYERS
NAME
Vision Age Diet
1. ____________________________________________ _____ _____
___
2. ____________________________________________ _____ _____
___
3. ____________________________________________ _____ _____
___
4. ____________________________________________ _____ _____
___
5. ____________________________________________ _____ _____
___
6. ____________________________________________ _____ _____
___
Coach(es)/Chaperone(s) (please provide a phone # that will be usable during
Nationals)
Name: _________________________________ Phone: _______________
___
Name: _________________________________ Phone: _______________
___
Name: _________________________________ Phone: _______________
___
By May 10, mail your registration form, medical forms, and waivers with
payment to: BSO (Nationals), 321 Joy Court, Bear, DE 19701.
2010 USABA Goalball National Championships
POOL PLAYER REGISTRATION
Please complete one form per pool player.
I wish to be placed on a _____ Men’s _____Women’s Team.
Name: __________________________________ Phone: _____________________
Address: ___________________________________________________________
____________________________________________________________
E-Mail: ________________________________________________ Age: _______
Please provide a phone # that will be usable during Nationals:
_________________
Emergency Contacts:
Name: _________________________________ Phone: _______________
Name: _________________________________ Phone: _______________
Vision Class
___ Totally Blind (B1)
___ best corrected 20/600 – finger movement; or field less than 5° (B2)
___ best corrected 20/200 – 20/600; or field of 5° to 20° (B3)
___ best corrected 20/70 – 20/200 (B4)
___ Dietary Request - Please specify on the medical form.
By May 10, mail your registration form, medical forms, and waivers with
payment to: BSO (Nationals), 321 Joy Court, Bear, DE 19701.
Blind Sports Organization
465 Maplewood Road
Springfield, PA 19064-2901
(302) 836-5784 * www.blindsports.org
WAIVER, RELEASE, and HOLD HARMLESS AGREEMENT
In consideration for being allowed to participate in the USABA Goalball
National Championships, hosted by Blind Sports Organization, June 4-6, 2010
at the University of Delaware; I hereby waive, release, and discharge USABA,
BSO, and the University of Delaware, including their employees, agents,
servants, and instrumentalities from any and all liabilities, causes of
action, rights or claims for death, disability, personal injury, property
damage, or theft, which may accrue to me as a result of my participation in
these events. I also understand that I may be held liable for any damage or
loss to the facilities caused by my actions. I will indemnify and hold
harmless: BSO and USABA, their officers and volunteers; the University of
Delaware and their employees, agents, servants, and instrumentalities from
any liabilities, claims, causes of action of any kind, and claims made by
other individuals or entities, which may result from any of my actions
during my participation in these events.
Print Name of Participant: _______________________________ DOB:
__________________
Signature of Participant (or Guardian if under 18):
_____________________________________
Print Signed Name: ____________________________________ Date:
___________________
PHOTOGRAPHY RELEASE
I give permission for myself, or my child, to be photographed for education,
promotion, or publicity purposes. I understand that the pictures may be
used in USABA’s and/or BSO’s newsletters, brochures, press articles, and
other publications, as well as on the organization’s website. Names may
appear in the caption. No contact information will be provided without my
express permission.
Name of Participant: ____________________________________________
Signature: ___________________________________________ Date:
____________________
Participant or Parent/Guardian for those
under 18
Blind Sports Organization
465 Maplewood Road
Springfield, PA 19064-2901
(302) 836-5784 * www.blindsports.org
MEDICAL FORM
This form is to be completed by all who participate in BSO sponsored
activities. It is for general informational purposes, which could be shared
with emergency medical professionals.
Name: _______________________________________ Date of Birth:
____________________
Address: _____________________________City: _____________State: ______ Zip:
_______
Phone: _________________________ E-Mail:
______________________________________
Health Insurance Company: _______________________ Policy Number:
_________________
Emergency Contact: ___________________________________ Phone:
__________________
Emergency Contact: ___________________________________ Phone:
__________________
Primary Care Physician: ________________________________ Phone:
__________________
Visual Diagnosis: ____________________________________ Visual Field:
______________
Best Corrected Acuity: Left Eye/OS - _______________ Right Eye/OD -
_________________
Note: You may participate in our activities if you are 20/70 with best
correction. However, to participate in National & International
Competition, you must be “legally blind” (20/200 – totally blind).
*Dietary Request – If you have marked the registration form and have any
reason to make a special dietary request, (diabetic, religious, allergies,
other), please specify the type(s) of food(s) you need to avoid:
____________________________________________________________
Brief Medical History
Please circle if any of the following apply.
Allergies Diabetes Heart Disease
Hypertension/High Blood Pressure
Retinal Issues Seizures Lung Disease/Asthma
Low Blood Pressure
Surgeries Other: ___________________________
If you circled any of the above, please explain (i.e. list all allergies,
treatments, medications, etc.):
________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
__
Please advise us immediately of any changes. Thank you!
Signature: ___________________________________________ Date:
____________________
Participant or Parent/Guardian for those
under 18
Note: For those under 18 who have seizures that are not currently controlled
by medication, a parent or guardian should be present during activities.
Howard Johnson Inn & Suites and Conference Center
1119 South College Avenue
Newark, Delaware 19713
Phone: 302-368-8521
Toll Free: 888-268-8521
Fax: 302-368-9868
www.hojonewark.com
We are very happy that your group will be staying with us during their
upcoming trip to Delaware! At the Howard Johnson Inn & Suites and
Conference Center, we give you the satisfaction of knowing that your group
will receive the most comfortable stay and friendly service at the best
rates in town!
The rates (excluding tax) for the Goalball Championships are:
*King Standard Room (1 King bed) – $59.99
*Queen Standard Room (2 Queen beds) – $59.99
**King Studio Suite (1 King bed and sleeper sofa) – $69.99
**Double Studio Suite (2 Double beds and sleeper sofa) –
$69.99
*The rates quoted are for 2 guests per room. **The rates for studios are
for 3 guests per room. Additional guests over the age of 18 will be $10 per
room per night.
Guests should call the Front Desk to make reservations under the group name
“Goalball Championships”. We are holding 70 rooms for your group Friday,
June 4 and Saturday, June 5, as well as 48 rooms on Sunday, June 6. These
rooms will be held until 5/14/10. After this date, the room block will be
released and regular room rates will apply based on availability. Please
make sure any individual cancellations are made at least 48 hours prior to
arrival. After this time frame, a one night no-show charge will apply per
hotel policy.
The Howard Johnson Inn & Suites and Conference Center completed full
renovations in 2009 including many upgrades. All standard rooms and suites
are over-sized (25% larger than standard hotels) and new from the floor up!
All accommodations include a refrigerator, microwave, and coffee maker.
Enjoy free high-speed wireless Internet in all guest rooms and suites as
well as public areas of the hotel. Forgot your computer? We also have a
Business Center located in our Front Lobby open to all guests of the hotel.
On-site, you will also find a seasonal outdoor pool, fitness center, and
convenient laundry facilities.
A complimentary Deluxe Continental breakfast with hot Belgian waffles is
included in all rates! Our newly renovated Breakfast Room is an enclosed
room and seats up to 60 people. You can even watch the morning news in the
Breakfast Room on our new 40” Plasma screen television! For quick snacks
later in the day, stop by our new Hojo Market located in the Front Lobby
where you will find an assortment of food and beverages 24 hours a day.
Our property is located in Newark, Delaware, at I-95 (DE Exit 1) & Rt. 896,
less than a mile from the University of Delaware. We are 25 minutes from
downtown Wilmington, DE, and we offer free parking.
TRANSPORTATION
Train
SEPTA – www.septa.org, (215) 580-7800
Regional Rail – R1 – PHL Airport to/from Center City
Philadelphia
Regional Rail - R2 - Newark to/from Center City
Philadelphia
Note: there are no trains from Newark on Sundays
AMTRAK – www.amtrak.com
The closest station is Wilmington, DE.
DART Busses run from the Amtrak station to the Univ. of
Delaware campus.
Check www.DartFirstState.com or call (800)
652-3278 for info. about
local bus service.
Plane
Philadelphia International Airport (PHL)
This is located less than an hour drive from the hotel.
*If you plan to use public transportation to get to
Newark, plan to arrive in PHL
no later than 1pm. Please see the train info.
above.
Baltimore-Washington International Airport (BWI)
This is located just over an hour drive from the hotel.
From BWI, you could use Amtrak (see above).
Airport Shuttle Service - Delaware Express – www.delexpress.com
or (302) 454-7800 serves BWI & PHL. Discount
available if you book on-line.
1. Click on this link: www.delexpress.com
2. Click on “Online reservations and Quotes” in the
box at the right side of the page
3. On the next page, do not click on anything.
Scroll down to the bottom of page.
4. You will see the Frequent User Login box. Type
in the word “Single” for one passenger for a
5% discount or “Express” for two or more passengers for a 25% discount.
5. Click the “Go” button next to the box.
6. This will take you to the Discount Portal page
where you can start making your reservations.
7. Please have your credit card handy.
8. If you have any questions or concerns, please
call (302) 454-7800.
Bus – Greyhound – www.greyhound.com
The closest station is Wilmington and it is located across the
street from the train station.
*For additional information, please call Heidi or Sandy (302) 836-5784 or
e-mail info at blindsports.org.*
Driving Directions
Automobile
To Howard Johnson Inn
- I-95 to Exit 1B (Newark Rt. 896 North)
- HoJos will be on your right within 0.1 mi.
To UD’s Carpenter Sports Building
- I-95 to Exit 1B (Newark Rt. 896 North)
- pass HoJos
- although 896 turns, stay straight going northbound on S. College Ave. to
the end where you
must turn left (2 lanes turn left – be in the right lane)
- Left on E. Main
- quick Right on N. College Ave.
- Right at 1st driveway (if you get to train tracks, you’ve gone too far)
and follow it around
until you see Carpenter Sports Bldg. Parking is all around that area.
Note: you may see
signs on UD’s campus indicating Permit Parking Only. You may ignore
them during
Nationals as the Campus Police will not be enforcing them (ticketing).
Remove
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hristellablue%40gmail.com&databaseId=UnitedStatesAssociationofB&jobRef=1026.
0.116993049> my name from all future email correspondence
Address postal inquiries to:
United States Association of Blind Athletes
33 North Institute St
Colorado Springs, CO 80903
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