2014 STATE OUTDOOR GAMES FINAL PACKET

EVENT DATES
October 3-5, 2014
LOCATION
JEFFERSON CITY, Missouri
HOSTS
City of Jefferson Parks & Recreation Department
Jefferson City Convention & Visitors Bureau
Capitol Plaza Hotel
Railwood Golf Course
COMMUNICATION DURING THE GAMES
EMERGENCY NUMBER
For all emergencies call 911 and then 660-888-1764
TEXT ALERTS
Text SOMO to 51555
You will receive announcements at the State Outdoor Games
Standard messaging rates apply
WEBSITE & FACEBOOK
Any announcements during the Games will be posted on:
o The SOMO website at www.somo.org/outdoor
o SOMO Facebook page at www.facebook.com/specialolympicsmo

WHATS INSIDE:
Item
Due Dates
Coaches Registration
Program Staff/Coaches Meeting
Opening Ceremony
Awards Presentations
Concession Stands
Healthy Athletes/Victory Village
Dance/Bingo
Coaches Reception
Fanwear Information
Inclement Weather
Housing
Meals
Sports Schedules: Bocce, Golf, Tennis &
Softball
Sports Schedule: Flag Football
Games Rules Committee/Protests
Agenda
Maps
Directions & Venue Addresses
Rooming List Form
Coaches Hours Form
Crisis Plan
Games Evaluation Form
Code of Conduct
Incident Immediate Action Steps Guide
Incident Report Form

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Dear Coaches:
Thank you for taking the time to be a Special Olympics Missouri coach, for taking the time to train your athletes, and for
making it possible for them to attend the State Outdoor Games.
The following is a Coaches Handbook, which is full of information and details about the Special Olympics Missouri State
Outdoor Games. Please take the time to read it completely to ensure that you are properly prepared for the games and to
make sure your athletes have the best time possible.
If you have any questions, comments or suggestions please contact any of the Games Management Team, SOMO staff
members or anyone working the information tents.
Our website, www.somo.org/outdoor will have up to date information and maps. Also, use the link on our site to reserve
your vehicle from Enterprise. SOMO will benefit!
Webster defines a coach as: One who instructs or trains; especially one who instructs players in the fundamentals of a
sport and directs team strategy.
SOMO defines a coach as: One who gives of their time and talent to encourage and train athletes to be more
physically fit and give them opportunities to achieve on and off the playing field; someone who is a friend, a mentor and a
fan.
Thanks for being a SOMO Coach!
Sincerely,
The SOMO Sports Team
Mandi Ballinger, Marketing & Communications Director
Gary Brimer, Sr. Director of Sports Initiatives
Johnathon Hankinson, Training Manager
Trish Lutz, Sr. Director of Programs
Tim Schuster, Sports Marketing Director
Susan Shaffer, Competition Director

DUE DATES
September 15
o Rosters
o Meal counts
o Room counts
o Coach/chaperone lists and Class A forms
September 21
o Rooming lists due to hotels
COACHES REGISTRATION
Coaches Registration for Thursday, October 2 arrivals will be at Capitol Plaza Hotel from 6-8 p.m.
Coaches Registration for Friday morning, October 3 arrivals for Golf, Bocce and Tennis will be at the
venues
Coaches Registration for Friday Afternoon/Evening, October 3 arrivals will be at the Capital Plaza
Hotel between 5-10 p.m.
Coaches Registration for Saturday, October 4 arrivals will be at the venues
ALL Coaches should turn in their Coaches Hours forms and pick up their registration packets during
registration.
Registration packets will include:
o Wristbands
o ID cards* for athletes and coaches
o Updated brackets and information
o Athletes and Coaches need to wear the ID Cards
o Chaperones should wear the wristbands.
o These will be your meal tickets and should be worn at all times when not competing for
security purposes.
*Note: ID cards are essential for the safety of our athletes. They are the first tool used to
identify an athlete that is lost or injured. It is imperative that athletes wear their ID cards
when they are not competing for their safety. Thank you for respecting and following this
very important procedure.
PROGRAM STAFF/COACHES MEETING
Friday, October 3 @ 8:30 am Bocce (63 Sports Complex)
Friday, October 3 @ 7:30 am Golf 9&18-Hole (Railwood Golf Course
Friday, October 3 @ 8:30 am Golf -- Individual Skills (Turkey Creek)
Friday, October 3 @ 7:30 am Tennis (Washington Park)
Friday, October 3 @ 9 pm ALL SPORTS -- Capitol Plaza in the Ballroom. It is located to the right as
you come in the Main Entrance.
OPENING CEREMONY
4

The Opening Ceremony will take place at Capitol Plaza Hotel on Friday, October 3 at 7 p.m.
Athletes who are participating in the Parade of Athletes should report to the Parade-staging area
by 6:30 p.m. One athlete per team may walk in the Parade.

VENUES
63 Sports Complex, 12575 Renz Farm (Bocce)

Binder Softball Complex, 200 S. Binder Lake Rd. (Softball)

Capitol Plaza Hotel, 415 W. McCarty St. (Opening Ceremony)

Jefferson City High School, 609 Union St. (Flag Football)

Turkey Creek Golf Center, 1616 Oilwell Rd. (Individual Skills Golf)

Railwood Golf Course, 12925 County Rd. 4037, Holt Summit (Golf)

Washington Park Tennis Courts, 711 Kansas St. (Tennis)

YMCA, 525 Ellis (Healthy Athletes, Dance, Bingo, Dinner)

AWARDS
Golf-9-18 Holes awards will be at Railwood Golf Course as divisions are completed.
Tennis awards will be at the Washington Park Tennis Complex as divisions are completed.
Flag Football awards will be at Jefferson City High School as divisions are completed.
Softball awards will take place at Binder Sports Complex as divisions are completed.
Bocce awards will take place at the 63 Sports Complex as divisions are completed.
CONCESSION STANDS
There will be a concession stand available at Railwood Golf Course during Golf Competition.
There will be a concession stand available at 63 Sports Complex (bocce).
There will be a concession stand available at Binder Sport Complex.
STRIVE: THURSDAY NIGHT-OCT 2, 2014 -6-8PM-CAPITOL PLAZA
STRIVE is the next generation of assessment program designed to test Special Olympics athletes
state of physical fitness. The program has been designed and validated by professionals in the
exercise science industry. In continuing the mission of providing opportunities for SO athletes to
improve their performance while becoming more fit, STRIVE provides a baseline measurement of
an athletes skills. Be sure to bring your athletes to it from 6-8 p.m. Thursday, Oct. 2 at Capitol
Plaza Hotel.
HEALTHY ATHLETES/VICTORY VILLAGE
Healthy Athletes will be held at the YMCA of Jefferson City from 5-7 p.m. on Saturday, October 4.

Disciplines offered will be Special Smiles (a free dental screening), FunFitness, Healthy Hearing,
Health Promotion and MedFest which offers free physicals.
Victory Village will be held at the YMCA of Jefferson City from 5:30-7 p.m. on Saturday, October 4.
Included in the fun will be sport activities and PIG RACES!!!!
5

DANCE & BINGO

The dance will be Saturday, October 4 from 7-9 p.m. at the YMCA
No food or drinks will be allowed on the dance floor.
Bingo will be from 7-9 p.m. at the YMCA.
COACHES RECEPTION
There will be a Coaches Reception during the dance from 7:30-8:30 p.m. in the multipurpose room
at the YMCA
FAN/SOUVENIRS CENTER
Friday, October 3 at Bocce 10 a.m.-2:30 p.m. -- 63 Sports Complex
Friday, October 3 at Opening Ceremony from 6:30-9 p.m. Capitol Plaza
Saturday, October 4 at Binder Sports Complex from 10 a.m.-2:30 p.m.
Saturday, October 4 at YMCA (Ellis Blvd) 5-9 p.m.
INCLEMENT WEATHER
If it rains during the competition, please stay at the venues or check with the front desk of your
hotel until it has been decided whether to play or not.
HOUSING:
Housing assignments will be made after September 15.
Rooming lists will be due to hotel by September 21 for all participants staying in hotel.
If needed, an overnight room for Thursday will be provided for participants in Bocce, Golf, and
Tennis.

Hotel:
Capitol Plaza Hotel
415 W. McCarty
Jefferson City, MO 65101
573-635-1234

Family Hotels:
Double Tree
422 Monroe St
Jefferson City, MO 65101
573-636-5101
Truman Hotel
1510 Jefferson St
Jefferson City, MO 65109
1-800-392-0202

MEALS SCHEDULE
Date
Friday, October 3
Friday, October 3
Friday, October 3
Friday, October 3
Friday, October 3
Saturday, October 4
Saturday, October 4
Saturday, October 4
Saturday, October 4
Sunday, October 13
Sunday, October 13

Meal
Lunch
Lunch
Lunch
Lunch
Dinner
Breakfast
Lunch
Lunch
Dinner
Breakfast
Lunch

Location
Time
Railwood Golf Course 9-18 holes
11:00 am to 1:00 pm
Turkey Creek-Individual Skills
11:00 am to 1:00 pm
Bocce-63 Sport Complex
11:00 am to 1:00 pm
Tennis-Washington Park
No meal served. Please plan accordingly.
At hotel
Per hotel schedule
Binder Sport Complex - Softball
11:00 am to 1:00 pm
Jefferson City High School-Flag Football
11:00am to 1:00pm
YMCA-Ellis Blvd.
4:30 pm to 6:30 pm
At hotel
Per hotel schedule
No lunch provided as tournament play concludes in time for everyone
to get on the road.

Meal Notes:
For efficiency and accuracy of counting meals by agency, we ask that each agency check in and
eat together so that we can check-in the entire group at one time.
Agencies who do NOT attend meals they have requested will be charged for the cost of the meal.

SPORTS
BOCCE
Date:
Location:
Lunch:

Friday, October 3
Shawnee Park Sports Complex
11 am to 1 pm

Event
Singles
Regulation Doubles & Teams
Unified Doubles & Teams

Check-In
Time
8:30 am
10:30 am
2:30 pm

Competition Time
9:00 am
Completion of Singles
Completes of Doubles and Teams

GOLF
Date:
Friday, October 3
Location:
Railwood Golf Course
All Golfers should check-in between 7:15-7:45 a.m.
Individual Skills will begin at 9 a.m.
We will use a shotgun start.
Lunch will be served for all golfers between 11a.m. 1 p.m.
Golf carts will be used for all Golfers ONLY.

Please let your families and fans know that there will be a limited number of golf carts available
to rent and will only be available IF athletes do not need them for competition.
Individual Skills GOLF
Date:
Friday, October 3
Location:
Turkey Creek
All Golfers should check-in between 8:15-8:45 am.
Individual Skills will begin at 9 a.m.
Lunch will be served for all golfers between 11 a.m.-1 p.m.
TELL FAMILY MEMBERS TO BRING A BAG CHAIR SO THEY CAN SIT AND WATCH!!!!!!
TENNIS
Date:
Location:

Friday, October 3
Jefferson City Parks and Recreation Tennis Complex-Washington Park

Check-in will begin at 7:30 a.m. at the tennis courts.

Competition will begin at 8 a.m.
Lunch will be served at 11 a.m.-1 p.m.
TELL FAMILY MEMBERS TO BRING A BAG CHAIR SO THEY CAN SIT AND WATCH!!!!

SOFTBALL
Date:
Location:
Lunch:

Saturday, October 4 & Sunday, October 5

Binder Sports Complex
11 a.m.-1 p.m.

Event
Team

Check-In Time
15 minutes prior
to game time

Individual Skills

8:15 a.m.

Competition Time
Fields will begin playing at 8:30 a.m. on Saturday
and 8:30 a.m. on Sunday.
Refer to brackets for YOUR specific game times
8:30 a.m.

Notes:
The time limit on all games will be 1 hour and 15 minutes. Please have your teams ready to play
as quickly as possible; this will be emphasized.
Due to time limits, there will be no warm-up allowed on the fields. Teams should warm-up between
fields prior to games.
Game time is forfeit time or unless you have a reasonable excuse and you will need to call the
emergency phone number (660) 888-1764 to report this to ensure your team wont forfeit.
FLAG FOOTBALL
Date:
Saturday, October 4
Location:
Jefferson City High School-(Football Field)
Lunch:
11 a.m.-1 p.m.

Competition will begin at 9 a.m.

Games will be scheduled every hour.
Due to time limits, there will be no warm-up allowed on the fields. Teams should warm-up between
fields prior to games and be ready to play at game time.
Game time is forfeit time unless you have a reasonable excuse and you will need to call the
emergency phone number (660) 888-1764 to report this to ensure your team wont forfeit.

GAMES RULES COMMITTEES

Should there be a protest; the following procedures shall be followed:
A protest must be filed within 30 minutes of the incident and must be filed by a certified head coach.
All protests shall be submitted by the head coach to the Event Manager at the competition where the
protest is being filed.
The Event Manager must sign off on the protest before it will be review.
The Games Rules Committee will make a decision within 30 minutes and will leave it in writing at the
Information tent/station at the competition venue.
The Games Rules Committees by sport are:
Bocce
Flag Football
Golf
Jan Stephens Johnathon
Steve
Hankinson
Wiederholt
Kathy Lowry
Tim Schuster
Diane Brimer
Trish Lutz
John Viertel
Gary Brimer

Softball
Trish Lutz

Tennis
Peggy Llewllyn-Neff

Gary Brimer
Scott Williams

Trish Lutz
Linda Wiederholt

RULES All rules can be found on the web site at http://somo.org/SportsOffered

NOTES:
Some things you might consider bringing with you:

Bag chairs
Umbrellas
Sunscreen
Jackets

AGENDA
Thursday, October 2
3:00 p.m.
6:00 pm to 8:00 pm
6:00 pm to 8:00 pm
Friday, October 3
7:15am to 7:45am
7:15am to 7:45am
8:00am to 2:00pm
8:00am to 3:00pm
8:30 am
8:30am
9:00am
9:00 am to5:00 pm
10:30 am
10am to 2:30pm
11:00 am to 1:00 pm
11:00 am to 1:00 pm
11:00 am to 1:00 pm
1:30pm
3:00 to 5:00 pm
5:00 to6:00 pm
9:00 pm
6:30 pm
7:00 to 8:00 pm
Saturday, October 4
8:30 am
9:00 am
9:00 am
10:30 am to 2:30 pm
11:00 am to 1:00 pm
4:30 pm to 6:30pm
5:00 pm to 7:00pm
5:30 to 7:00 pm
5:00pm to 9:00 pm
7:30 to 8:30 pm
7:00 to 9:00 pm
7:00 to 9:00 pm
Sunday, October 5
8:30 am
11:00 am

Arrival of athletes
STRIVE-Capitol Plaza Hotel
Coaches Registration Capitol Plaza
Check-in for 9-18 holers Golfers Railwood Golf Course
Check-in for TennisJefferson City Park and Rec Tennis Complex
Golf CompetitionRailwood Golf Course
Tennis Competition-Jefferson City Parks and Rec Tennis Complex
Check-in for Regulation Bocce Singles-63 Sports Complex
Check-in for Individual Skills Golf-Turkey Creek
Golf Individual Skills Competition-Turkey Creek
Bocce Competition-63 Sports Complex
Check-in for Regulation Bocce Doubles-63 Sports Complex
Fanwear Center-63 Sports Complex
Lunch for Tennis-Jefferson City Parks and Rec Tennis Complex
Lunch for Golfers-Railwood Golf Course and Turkey Creek
Lunch for Bocce-63 Sports Complex
Check-in for Regulation Bocce Teams Unified Doubles-63 Sports Complex
Arrival and check-in at hotel
Coaches RegistrationCapital Plaza Hotel
Coaches Meeting Capital Plaza Hotel in the Ballroom
Line-up for Parade of AthletesCapital Plaza Hotel
Opening CeremoniesCapital Plaza Hotel

Softball Competition beginsBinder Sports Complex

Flag Football Competition begins Jefferson City High School
Softball Individual Skills FinalsBinder Sports Complex
Fanwear Center-Binder Sports Complex
Lunch-Binder Sport Complex
Dinner-YMCA(Ellis Blvd)
Healthy Athletes-YMCA
Victory Village-YMCA
Fanwear Center-YMCA
Coaches Reception - Multipurpose Room YMCA-Downstairs
BingoYMCA
Dance YMCA

Softball Competition beginsBinder Sports Complex

Departure

SPECIAL OLYMPICS
FIRST REPORT OF ACCIDENT / INCIDENT
Address to Venues for the 2014 Special Olympics State Outdoor Games:
Venue Addresses (for GPS and Google maps purposes):
Venue
Capitol Plaza Hotel

Address

Railwood Golf Course

12925 County Rd 4037, Holt

Summit, MO 65043

9-18 Golfers

Turkey Creek

1616 Oilwell Rd, Jefferson City,

MO
711 Kansas St, Jefferson City,
MO 65101
200 or 300 South Binder Lake
Rd

Individual Skills

Jefferson City Parks and Rec

Tennis Courts-Washington Park
Binder Sports Complex

415 W McCarty St, Jefferson

City, MO

Event
Coach Registration/Hotel
Stay/STRIVE/Opening Ceremony

Tennis
Softball

Jefferson City, MO 65109

63 Sports Complex
YMCA
Jefferson City High School

12575 Renz Farm, Jefferson

City, MO
525 Ellis, Jefferson City, MO

Bocce

609 Union St, Jefferson City,

MO

Flag Football

HA/VV/Dinner/Dance

SPECIAL OLYMPICS
FIRST REPORT OF ACCIDENT / INCIDENT

Special Olympics Missouri

Rooming Assignment List
SOMO Area Program Staff:

Area/Agency:

Room #

Room #

Person 1:

Person 1:

Person 2:

Person 2:

Person 3:

Person 3:

Room #

Room #

Person 1:

Person 1:

Person 2:

Person 2:

Person 3:

Person 3:

Room #

Room #

Person 1:

Person 1:

Person 2:

Person 2:

Person 3:

Person 3:

Room #

Room #

Person 1:

Person 1:

Person 2:

Person 2:

Person 3:

Person 3:

Room #

Room #

Person 1:

Person 1:

Person 2:

Person 2:

Person 3:

Person 3:

SPECIAL OLYMPICS
FIRST REPORT OF ACCIDENT / INCIDENT

Special Olympics Missouri

Coaches Hours
Bocce, Flag Football, Golf, Tennis, Softball and Soccer Season
Coachs Name (Please Print)
Email
SOMO Area
Agency Name

Total Hours

Exampl
e

Practice/Paperwor
k hours per work

Number of weeks
of practice

Area Competition

Bocc
e

Flag
Football

Golf

Tenni
s

Softba
ll

Soccer

District
Competition
Regional
Competition
State
Competition
Facility Used
Rental Fee/Cost
per person

72
Railwoo
d Golf
Course
$25

If Donated, Value
of In-Kind
Hours should include time spent coaching athletes, travel to and from competition, and
paperwork
Signature:
Date:

SPECIAL OLYMPICS
FIRST REPORT OF ACCIDENT / INCIDENT
THANK YOU

Crisis Plan
What to do in a Crisis or Emergency at a Special Olympics Event:
Examples of a crisis: medical emergency, alleged rape, alleged sexual misconduct, alleged assault,
death, or an unexpected situation or incident posing potential or actual harm to Special Olympics Missouri
(SOMO) reputation or viability.

Dealing with the Crisis:

1. Protect those involved

In the case of a medical emergency i.e. heart attack, seizure, accident, etc. contact medical assistance
immediately.

In the case of alleged assault, alleged rape or related emergency, keep the involved parties separated
and protected, the Area Director should contact medical assistance if needed.

2. Notify your Area Director immediately of the situation

If admitted to the hospital, Area Program Staff should notify Mark Musso, SOMO President and call the
insurance company, 1-800-932-2744

3. Dont talk to the media

Under no circumstances should anyone except a designated spokesperson make any comment to the
media regarding the crisis situation. If approached by the media please say, A statement will be
released by Special Olympics Missouri after the organization has gathered all the facts and had time
to review the situation.

The designated spokesperson is Mark Musso, SOMO President. If Mark is not reachable at the event,
please call the emergency number at 660-888-1764.

SPECIAL OLYMPICS
FIRST REPORT OF ACCIDENT / INCIDENT

SOMO State Games Evaluation

Please provide us with some feedback on the following topics in order to make improvements (3 is the
highest; 1 is the lowest).
1. Opening Ceremonies - Appropriate, Too Short/Long, etc.
Overall Rating 3 2 1
2. Individual Skills Competition - Organization, Rules, Heats, etc.
Overall Rating 3 2 1
3. Team Competition - Pairings, Referees, Rules, etc.
Overall Rating 3 2 1
4. Food - Complete Meal, Not Enough, etc.
Overall Rating 3 2 1
5. Registration - Correspondence, Deadlines, Rule Changes, etc.
Overall Rating 3 2 1
Other Comments:
Overall Rating 3 2 1

Use Back of Form if necessary

SPECIAL OLYMPICS
FIRST REPORT OF ACCIDENT / INCIDENT
SPECIAL OLYMPICS MISSOURI (SOMO)
PARTICIPANT CODE OF CONDUCT
Board Approved August 9, 2003
The purpose of the SOMO Code of Conduct (the Code) is to encourage all athletes, coaches, family
members, spectators, chaperones, volunteers, members of the SOMO Board of Directors, and
officials participating in a SOMO-sponsored activity (Participants) to conduct themselves in a
way that brings credit and honor to themselves and to SOMO. The Code also establishes a uniform
procedure for resolving conduct infractions to ensure that all Participants are treated fairly.
Nothing in this Code will be deemed to restrict the individual freedom of a Participant in matters not
affecting SOMO, their status as a SOMO Participant or the well being of the team. Participants will have
complete freedom in choices of appearance, life-style, behavior, or speech while not traveling or
participating in a SOMO-sponsored activity, provided their statements and actions do not adversely affect
the name and reputation of SOMO.
All SOMO Participants will:
1.

Conduct themselves in a sportsmanlike manner at all times, showing respect for other
Participants through words and actions.

2.

Respect the spirit of fair-play and non-violence, and behave accordingly in competition.

3.

Maintain dignity at the Opening, Closing, and Awards Ceremonies at all SOMO activities.

4.

Be responsible for their personal belongings at all times and assist in maintaining the
cleanliness, safety, and security of their assigned areas.

5.

Refrain from smoking in competition or athlete training venues.

6.

Fully abide by the rules of SOMO and the Games Management Team of any SOMOsponsored activities.

7.

Fully abide by the provisions of the Athlete Code of Conduct Pledge or Coach Code of
Conduct Pledge, if applicable.

SOMO Participants understand that if they violate the Code, they will be subject to the SOMO
disciplinary procedures, including being held financially and legally responsible for any
damage that they purposely or knowingly cause.

SPECIAL OLYMPICS
FIRST REPORT OF ACCIDENT / INCIDENT
ATHLETE
CODE OF CONDUCT PLEDGE
Sportsmanship

I will practice good sportsmanship.

I will act in ways that bring respect to me, my coaches, my team and Special Olympics.

I will maintain dignity at the Opening, Closing, and Awards Ceremonies at all Special
Olympics activities.

I will not use curse words.

I will not insult other persons.

I will not fight with other athletes, coaches, volunteers or staff.

Training and Competition

I will train regularly.

I will learn and follow the rules of my sport.

I will listen to my coach and the officials and ask questions when I do not understand.

I will always try my best during training, divisioning and competitions.

I will not hold back in preliminary competition just to get into an easier finals competition
division.
Responsibility for My Actions

I will not make inappropriate or unwanted physical, verbal or sexual advances on others.

I will not smoke in non-smoking areas.

I will not drink alcohol or use illegal drugs at Special Olympics activities.

I will not take drugs for the purpose of improving my performance.

I will be responsible for my personal belongings at all times and will assist in maintaining
the cleanliness, safety, and security of my teams assigned area.

I will obey all laws and Official Special Olympics Sports Rules for my respective sport(s).

SPECIAL OLYMPICS
FIRST REPORT OF ACCIDENT / INCIDENT
COACH
CODE OF CONDUCT PLEDGE
Respect for Others
I will respect the rights, dignity and worth of athletes, coaches, other volunteers, friends and
spectators in Special Olympics.
I will treat everyone equally regardless of sex, ethnic origin, religion or ability.
I will be a positive role model for the athletes I coach.
Ensure a Positive Experience
I will ensure that for each athlete I coach, the time spent with Special Olympics is positive.
I will respect the talent, developmental stage and goals of each athlete.
I will ensure each athlete competes in activities that challenge that athletes potential and are
appropriate to that athletes ability.
I will be fair, considerate and honest with athletes, using simple, clear language.
I will ensure that accurate scores are provided for entry of an athlete into any event.
I will instruct each athlete to perform to the best of the athletes ability at all competitions
(including preliminary events) in accordance with the Official Special Olympics Sports Rules.
Act professionally and Take Responsibility for My Actions
My language, manner, preparation, appearance and presentation will demonstrate high standards.
I will display control, respect, dignity and professionalism to all involved in the sport (athletes,
coaches, opponents, officials, administrators, parents, spectators, media, etc), and encourage
athletes to demonstrate the same qualities.
I will not drink alcohol, smoke or take illegal drugs while representing Special Olympics at training
sessions or during competition.
I will refrain from any form of personal abuse towards athletes and others, including verbal,
physical and emotional abuse.
I will be responsible for supervising the conduct of athletes in my care at SOMO-sponsored
activities.
I will be alert to any form of abuse from other sources directed toward athletes in my care.
I will be on hand and available at all times during any SOMO activity or event in which I have
chosen to participate, and will remain responsible for the athletes in my care from the time of my
arrival until the time my departure.
Quality Service to the Athletes
I will seek continual improvement through performance evaluation and ongoing coach education.
I will be knowledgeable about the skills and techniques of the sport(s) I coach.
I will provide a planned training program.
I will keep copies of the medical, training, and competition records for each athlete I coach.
I will teach and follow the Official Special Olympics Sports Rules for the sport(s) I coach.
Health and Safety of the Athletes
I will ensure that the equipment and facilities at practice sites and SOMO-sponsored activities are
safe to use.
I will ensure that the equipment, rules, training and the environment are appropriate for the age
and ability of the athletes I coach.
I will review each athletes medical form and be aware of any limitations on that athletes
participation noted on that form.
I will encourage athletes to seek medical advice when required.
I will maintain the same interest and support towards sick and injured athletes.
I will allow further participation in training and competition only when appropriate.

SPECIAL OLYMPICS
FIRST REPORT OF ACCIDENT / INCIDENT
U.S. Program/Area: _Missouri
Injured Person/Party Information

__ Date of Incident: ________________

Date of Birth: /_____/_____

Age: ______

Name: _____________________________________________________________________
(Last)
(First)
(MI)
Address: ___________________________________________________________________
(Street)
(City)
(State)
(Zip)
Home Phone: (______)_______-________
Work Phone: (______)________-____________
Gender: Male
Female
Social Security Number: ______-____-________

Type of Injury/ Accident:

Bodily Injury
Property Damage
Automobile
Other: _______________

Injured Party:
Athlete
Volunteer
Coach
Employee
Spectator
Unified Partner
Property Owner
Other: _______

Description of Accident (If automobile accident occurred, please attach a copy of the police report).
Describe how the accident occurred (Attach a separate sheet if necessary): _______________________________________________________
___________________________________________________________________________________________________________
__________________________________________________________
Sport
___________________________________________________________
Power Lifting
Alpine Skiing
Site / event where accident occurred: _____________________________
Body Part Injured:
Relay Game
Aquatics
Head
Roller Skating
Athletics
Accident Occurred During:
Disposition:
Neck
Sailing
Badminton
Training/Practice
Released to parent
Torso
Snowboarding
Baseball
Competition
Refusal of care
Back
Snowshoe
Basketball
Traveling to or from SO event
Refer to doctor
Hand (L / R)
Soccer
Bocce
Other: __________________
Refer to hospital or clinic
Finger (L / R)
Softball
Bowling
Type of Injury:
Medical attention
Elbow (L / R)
Speed Skating
Cheerleading
Severe cut w/ bleeding
EMS transport
Shoulder (L / R)
Swimming
Cross Country Ski
Less serious bruise or cut
Patient requested EMS transport
Leg
(L / R)
Table Tennis
Cycling
Break/fracture
Released to personal vehicle
Knee
(L / R)
Team Handball
Equestrian
Concussion
Police
Thigh (L / R)
Tennis
Figure Skating
Paralysis
Ambulance
Shin
(L / R)
Track & Field
Floor Hockey
Fatality
Report only
Toe
(L / R)
Volleyball
Golf
Other: _______________
Other: _____________________
Other: ________ Other: _____________
Gymnastics
Kickball

Contact/Care Provider Information If an athlete or underage volunteer was injured, please identify the care provider and/or responsible party (e.g. parent,
legal guardian).
Relationship to the injured person: _________________________
Employer Name: _____________________________________
Name: _______________________________________________
Employer Address: ___________________________________
Address: _____________________________________________
___________________________________________________
_____________________________________________________
Work Phone: (______)________-___________
Home Phone: (______)_______-________
Does the injured person have medical insurance? Yes
No
If yes, insurance is provided by:
Injured Person Care Provider/Responsible Party
Please provide name of Company and Policy Number: __________________________________________________

Witness Information (Please provide names and phone numbers of any witnesses to the incident)
Witness #1 Name: _________________________________________________
Witness #2 Name: _________________________________________________

Daytime Phone: (______)_______-________

Daytime Phone: (______)_______-________

Special Olympics Official / Representative (other than claimant)

Name: __________________________________________________________
Signature: _______________________________________________________

Daytime Phone: (______)_______-________

Send completed form to:

If injury was serious or a fatality:

Special Olympics Missouri 1001 Diamond Ridge, Suite 800, Jefferson City, MO 65109 Fax: 573-635-8233
IMMEDIATELY notify American Specialty Insurance & Risk Services, Inc.
Telephone: (800) 566-7941 (24 hours a day / 7 days a week)
Form Updated 2/25/09