Athlete Registration Form

Northland Junior Disability Sports Day - Athlete Registration Information
Friday 16 June 2017
The Junior Disability Sports Day is for physically disabled young people, including vision and hearing impaired 7-21 years of age and will offer a wide range of adapted and
disability specific sports to try for physically disabled young people (Ambulant (able to walk), Wheelchair users, Vision and Hearing impaired).
If you have any questions, please do not hesitate to contact: Leesa Andrewes: [email protected] 021 34 0010 or Maia Lewis: [email protected] 021 995 951.
We are happy to be collaborating with students from the NorthTec Sport and Recreation Course this year who will assist in both the planning and delivery of this event.
Registration Please ensure you FULLY complete, SIGN and return the athlete registration from included at the end of this information. If you have any questions with
regards to completing the registration form, please do not hesitate to contact us. Entries need to be received no later than Wednesday 24th May 2017.
Projected Timetable
Start
9.00am
9.40am
Warm Up
9.45am
Session 1
10.00am
Finish
9.30am
9.45am
Venue
ASB Stadium
ASB Stadium
Registration – please arrive during this time to allow for parking and registration
Event briefing
10.00am
ASB Stadium
Taekwondo
10.45am
ASB Stadium
10.45am
Session 2
11.00am
11.00am
ASB Stadium
Vision Impaired (VI)
Sports session #1
Break
11.45am
ASB Stadium
11.45am
12.30pm
Trigg Arena
Session 3
12.30pm
2.00pm
Trigg Arena
2.00pm
2.15pm
Trigg Arena
Balloon Soccer &
Powerchair Football
Badminton
Vision Impaired (VI)
Boccia
Wheelchair Basketball
Sports Session #2
Lunch break and transfer to Trigg Arena, Park Ave, Kensington (weather permitting)
Field Events: Long Jump, Discus, Shot Put
Track Events: 70m, 100m, 200m, Powerchair (PC) Slalom
Prize-giving
Please note: In the event of
wet weather the Athletics
events will be modified and
delivered at ASB Stadium
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Description of Sports:
Sport
Deliverer
Ideal for
Brief description
Taekwondo
Dean Baker
people who have movement in their arms or
legs
Taekwondo is an inclusive martial art and Paralympic sport. Participants will have the
opportunity to take part in a Taekwondo warm up at the beginning of the day.
Vision Impaired (VI) Sports
Blind Cricket
NorthTec students
people with a visual impairment
Goalball
NorthTec students
people with a visual impairment
VI Football
NorthTec students
people with a visual impairment
Powerchair
Football
Northland
Powerchair
Football Club
powerchair users (must have good control of a
powerchair)
Balloon Soccer
Northland
Powerchair
Football Club
Parafed Northland
manual and powerchair users (must have good
control of a powerchair)
Northland
Badminton Assc.
Aaron Spence
Northland Mens
Wheelchair
Basketball
people who have arm movement
Blind Cricket is similar to traditional cricket however; the ball has a bell inside and is rolled
instead of thrown. The batters use a sweeping action to hit the ball and the scores work slightly
differently too.
Goalball is the only true hand-ear coordination game in the world. Played in an area the size of a
volleyball court, a 1kg ball with bells inside is rolled down the court towards a goal that is
defended by 3 players who must listen for the ball and put their bodies in front of it to protect
their goal. A goalball team can have up to six members, with three people on the court at a time
(other 3 can ‘sub-on’ at any time)
Played by both blind and partially sighted players, VI Football is played on a solid surface. There
are five players in each team and outfield players must wear eye-patches and blindfolds. The
goalkeeper is sighted, but cannot leave the area. The football contains ball bearings so that it
makes a noise when it moves and there are no off-side rules.
Powerchair football is played in a gymnasium on a regulation basketball court. Two teams of four
players use power chairs to attack, defend and spin-kick a 13 inch football in an attempt to score
goals. This is a great sport for helping you develop your ability to manoeuvre your chair and work
in a team. Football guards provided and one spare powerchair available on the day.
A 5-a side sport similar to powerchair football, balloon soccer uses a specialised balloon similar in
size to a weather balloon and as light as a normal balloon. One spare powerchair and manual
wheelchairs are available on the day.
Boccia is a game of skill and strategy and is a truly inclusive sport for all. Similar to lawn bowls
and petanque, Boccia is a non-contact target sport that is played indoors with soft leather balls
on a smooth rectangular court and can be played as individuals, in pairs or teams of three. In this
session, you can learn the basics of the sport and get some top tips for the competition that
follows later in the year.
Adapted Badminton is a Paralympic sport that can be enjoyed by most. Northland Badminton
Association will work with you to ensure you can join in and learn the game.
Boccia
Adapted
Badminton
Wheelchair
Basketball
wheelchair and powerchair users, as well as
those who have limited strength and hand
function
manual wheelchair users/lower limb amputees
Played on the size of a standard basketball court, with a standard ball, the rules of this game are
very similar to those you see in basketball.
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Code of Conduct and Photography
Please read the following code of conduct and the photography policy. Please insure that all athletes, teachers and parents consent to the photography policy and abide by the code of
conduct. You will need to sign at the bottom of the registration form to indicate that all athletes, teachers and parents consent to and abide by these terms. We understand that there may
be circumstances where photography of athletes and use of their images may be sensitive. Please contact Leesa Andrewes directly at [email protected] or by phone on 021 34
0010 where we may need to exercise discretion with regard an athlete in your group.
Code of Conduct:
-
-
Athletes and supporting / accompanying teachers and parents are to:
o Respect the rules of each sport and do as the coach asks at all times
o Acknowledge and appreciate that this event is run by volunteers
o Encourage fair play
o Encourage sportsmanship
o Win with grace and lose with dignity
Athletes are to:
o Have a positive attitude and actively participate in the sports
-
Supporting / accompanying teachers and parents are to:
o Remain with their athletes all day
o Support athletes in their sport, but allow them to play without you as much
as possible
o Carry all necessary medication and emergency contact details for the
athletes
o Be responsible for athlete behaviour and discipline
Photography policy:
This is a very exciting event for the Halberg Disability Sports Foundation and Parafed Northland; it is also a great opportunity to showcase our work to a wider audience than those
attending. With this in mind, we plan to invite some newspapers to help us. As such some athletes may be interviewed / photographed during the event.
In order to promote the work of the Halberg Disability Sport Foundation and Parafed Northland, we often profile these events, and their participants in online, print and social media, as well
as public relations material and video footage. All material collected is used specifically to enhance the work of the Halberg Disability Sport Foundation and Parafed Northland. Images and
content may also be supplied to external news media to further achieve this goal. It is important for our ongoing success that we continue to develop this material.
On behalf of the Halberg Disability Sport Foundation and Parafed Northland, thank you for your co-operation.
Awards and Prize Giving
This event is predominantly an opportunity to try a new sport, however there will be a number of awards and prizes on offer throughout the day. Awards and prizes will be presented at the
prize giving at the conclusion of the day.
Other information
Event Addresses
ASB Leisure Centre - 193 Western Hills Drive, Whangarei, 0110
Trigg Sports Arena – Park Ave, Whangarei, 0110
Athletes must bring Food and water, wear sports clothing/activewear and sports shoes, warm clothes for outdoors, hat and sunblock for outdoors
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Athlete Registration Form: Please complete & return by Wednesday 24 May 2017.
School: ____________________________________________________________________
Your Details (details of the person completing this form)
Name: _______________________ Phone: ____________________ Email: ______________________________________________
Please insure you sign the section at the bottom of this form.
Group Supervisor Details (details of the teacher/parent responsible for your group – must be present at event)
Name: _______________________ Phone: ____________________ Email: ______________________________________________
*Athletes must enter an event in each session under one of the classifications. If you are unsure which classification to choose, please contact us. Athletes who use a wheelchair, but are ambulant (able to walk)
may choose to change classification depending on the sport i.e. John may want to use his chair in one event, but may also want to try the ambulant event.
Athlete’s name
e.g. John Smith
Gender
M/F
School
Year
Age
M
5
10
Primary Physical
Impairment
*Athlete Classification
Sports
Select ONE sport in SESSIONS 1 & 2
You may select more than one event in SESSION 3
Cerebral palsy
Ambulant
Session 1
VI Sports #1
Balloon Soccer &
Powerchair Football
Badminton
Wheechair
Wheelchair
Ambulant
Session 2
Session 3
PC Slalom
Session 1
VI Sports #2
Long Jump
70m
VI Sports #1
Boccia
Discus
100m
WC Basketball
Shot Put
200m
Badminton
Session 2
Session 3
PC Slalom
VI Sports #2
Long Jump
70m
(please select one for each
sport)
Power chair user/ Manual
wheelchair user / Ambulant /
Visual Impairment /Loss of
limb - upper/lower
Balloon Soccer &
Powerchair Football
Boccia
Discus
100m
WC Basketball
Shot Put
200m
Form continues over page – please also complete the declaration below before returning form.
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Athlete’s name
Gender
M/F
School
Year
Age
Primary Physical
Impairment
*Athlete Classification
Sports
Select ONE sport in SESSIONS 1 & 2
You may select more than one event in SESSION 3
(please select one for each
sport) Power chair user/
Manual wheelchair user /
Ambulant / Visual Impairment
/Loss of limb - upper/lower
Session 1
VI Sports #1
Balloon Soccer &
Powerchair Football
Badminton
Session 2
Session 3
PC Slalom
Session 1
VI Sports #2
Long Jump
70m
VI Sports #1
Boccia
Discus
100m
WC Basketball
Shot Put
200m
Badminton
Session 2
Session 3
PC Slalom
Session 1
VI Sports #2
Long Jump
70m
VI Sports #1
Session 2
Session 3
PC Slalom
Session 1
VI Sports #2
Long Jump
70m
VI Sports #1
Session 2
Session 3
PC Slalom
Session 1
VI Sports #2
Long Jump
70m
VI Sports #1
Session 2
Session 3
PC Slalom
VI Sports #2
Long Jump
70m
Balloon Soccer &
Powerchair Football
Boccia
Discus
100m
Balloon Soccer &
Powerchair Football
Boccia
Discus
100m
Balloon Soccer &
Powerchair Football
Boccia
Discus
100m
Balloon Soccer &
Powerchair Football
Boccia
Discus
100m
WC Basketball
Shot Put
200m
Badminton
WC Basketball
Shot Put
200m
Badminton
WC Basketball
Shot Put
200m
Badminton
WC Basketball
Shot Put
200m
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Declaration – please complete and sign
As a teacher at ……………………………………………………………………………… (school), I ………………………………………………….………………………………………….. (full name), I confirm that I have:
-
to the best of my knowledge completed this form using correct and true details for myself and those of our group supervisor.
to the best of my knowledge completed this form using correct and true details for each athlete
read and am aware of the details of the event as included with this registration form and understand I am responsible for passing on these details as required to relevant parents,
teachers and athletes
circulated and sort permission from all parents, athletes and teacher with regards to the photography policy and am aware that I need to contact Parafed Northland directly to
advise of any athletes where discretion needs to be exercised with regards to capture and use of their image and/or name
circulated and sort agreement from all parents, athletes and teachers with regards to the code of conduct
Signature ………………………………………………………………………………………………… Date………………………………………………………
Please send all completed registrations to Leesa Andrewes – Event Coordinator, Parafed Northland
Email: [email protected]
by Wednesday 24th May 2017.
Thank You!
Enquiries to: Leesa Andrewes: [email protected] 021 34 0010
or
Maia Lewis: [email protected] 021 995 951
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