Registration Tournament Registration Contact InformationName* First Last Date of Birth Month Day Year Phone*Email* Address* Street Address City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Player DetailsI am a Special Olympics Illinois Athlete* Yes No I am a Unified Partner* Yes No Which game system do you play on?* PC Xbox Playstation Nintendo Switch Choose all options that may apply to youWhat is your gamertag?* *This is the name that you use when you play online games*What is your Epic ID?* *This is the name that you use when you play games created by Epic (Ex. Rocket League, Fortnite, etc.)*What is your Rocket League rank?*UnrankedBronzeSilverGoldPlatinumDiamondChampionGrand ChampionSupersonic LegendAre you participating with a school or team? If so, please list the school/team below. What Region are you with in Special Olympics Illinois?*Region ARegion BRegion CRegion DRegion ERegion FRegion GRegion HRegion IRegion JRegion KDo you know who your partners are?* Yes No If you know your partners, please list their names here. *Use the + icon to add more names to the list with a maximum of 5* Please click the link below to join the Special Olympics Illinois Discord. This will be the main form of communication for all things eSports. Special Olympics Illinois Discord ChannelBy checking the box below, you indicate that you have joined our Discord server.* I have joined the Discord Registration SummaryAnyone registering as a Unified Partner will need a valid Class A on file or complete one on line – Class A Form If you are unfamiliar with the Special Olympics Illinois Code of Conduct, please click the link below to read more about it. Special Olympics Illinois Athlete Code of Conduct By checking this box you agree to the Special Olympics Illinois Code of Conduct found in the link above.* I Agree If you have not yet filled out a Virtual Participation waiver, please follow the link below to complete the form. If an athlete already has a valid Medical on file, then this step is not required. Virtual Event Waiver A Virtual Participation waiver will be required for each athlete unless they have a valid Medical on file. By checking the box below, you agree to the terms and conditions of the Virtual Participation Waiver.* I Agree
