• Virtus Sport Eligibility Application

    Virtus Sport Eligibility Application

    For U.S. Athletes with Intellectual Impairments
  • Welcome! What are you using this form to do?*
  • Application Contact

  • Who's filling out this form?*
  • Format: (000) 000-0000.
  • Todays Date
     - -
    4 digit year, 2 digit month, 2 digit day
  • Editable Submission Date
     - -
    4 digit year, 2 digit month, 2 digit day
  • New Athlete Application

    To make things easier — this online form is replacing our previous PDF version!
  • Image of PDF Application
  • Have you already downloaded and signed our previous PDF Application?
  • Browse Files
    Drag and drop files here
    Choose a file
    Cancelof
  • Sports & Events

  • Image field 612
  • Switchbacks Logo
  • One Knoxville Logo
  • Image field 616
  • United FC Logo
  • Winthrop Logo
  • Upcoming Competition Date
     - -
  • Select all sports the athlete competes in so we can share opportunities!
  • Event Date (Single Field)
     - -
    4 digit year, 2 digit month, 2 digit day
  • Athlete Information

  • Submit Additional Information

  • Who's Application Fee Are You Paying?

  • Browse Files
    Drag and drop files here
    Choose a file
    Cancelof
  • Athlete Date of Birth*
     - -
  • Athlete Date of Birth (Single Field)*
     - -
    2 digit day, 2 digit month, 4 digit year
  • Athlete Gender (as stated on US Passport or State ID)*
  • Does the athlete already have their US Passport?*
  • Browse Files
    Drag and drop files here
    Choose a file
    Cancelof
  • Browse Files
    Drag and drop files here
    Choose a file
    Cancelof
  • Browse Files
    Drag and drop files here
    Choose a file
    Cancelof
  • Parent or Legal Guardian

  • Format: (000) 000-0000.
  • Does parent/guardian have same address as athlete?*
  • Diagnosis & Supporting Documents

    If you're not sure what to provide your School IEP is a good place to start!
  • Does athlete have Autism?*
  • Does athlete have Down Syndrome?*
  • You noted the athlete does not have Down Syndrome or Autism.

    This means it's important the documention you provide includes:

    1. A report showing most recent IQ scores. 
    2. We're also looking for recent Vineland or ABAS Adaptive scores.
    3. A formal diagnosis of Intellectual Disability made by a psychologist.

    *Please provide the most recent Psychologist's testing and reports you have for National eligibilty review. 

    (For full International Virtus requires IQ & Adaptive testing within the last 5 years so some athletes may need to be re-assessed to pursue higher level events.)

  • Browse Files
    Drag and drop files here
    Choose a file
    Cancelof
  • Browse Files
    Drag and drop files here
    Choose a file
    Cancelof
  • Sample Genetic Report
  • Browse Files
    Drag and drop files here
    Choose a file
    Cancelof
  • Browse Files
    Drag and drop files here
    Choose a file
    Cancelof
  • Browse Files
    Drag and drop files here
    Choose a file
    Cancelof
  • Internal Review

  • Internal Status Board
  • Internal Virtus Groups Confirmed
  • Internal Virtus Not Eligible
  • Internal II1 Form Checklist
  • Internal II2 Form Checklist
  • Internal Date NEO Endorsement
     - -
    2 digit month, 2 digit day, 4 digit year
  • Internal Date Submitted to Virtus
     - -
    2 digit month, 2 digit day, 4 digit year
  • Internal Date Virtus Request Additional
     - -
    2 digit month, 2 digit day, 4 digit year
  • Internal Date Virtus Confirmed
     - -
    2 digit month, 2 digit day, 4 digit year
  • Emergency Medical

    This section is for possible future Athletes Without Limits Trips to Virtus Events — Other organizations and events will have their own medical forms.
  • Dietary Needs:
  • Does Athlete have Allergies?
  • Allergies: (select all)
  • Does Athlete have Asthma?
  • Does Athlete have Sickle Cell Disease?
  • Medications & Sport

    This section is for future Athletes Without Limits Trips to Virtus Events. Some medications may require Additional Paperwork — other organizations may have their own medication policies.
  • Does the athlete take any prescription medications?*
  • CURRENT MEDICATIONS
    Rows
  • Internal Medication Review
  • Browse Files
    Drag and drop files here
    Choose a file
    Cancelof
  • Releases & Signatures

    To protect athletes both Athlete & Parent/Guardian signatures are required when e-signing.
  • Virtus International Logo
  • Virtus Athlete Declarations:
  • AWL Logo
  • Athletes Without Limits USA Privacy Policy, Liability & Photo Release:
  • Since you've already signed the PDF application
    electronic signatures aren't needed and have been hidden. 

  • Thanks for helping with this application! 
    Since you're not a 
    legal guardian we'll send you a pre-filled PDF Release Form you can use to gather signatures from the athlete and their parent/guardian. 

  • Is your parent or legal guardian there with you to sign the application below?
  • Let's Double Check Your Email: 
    We'll send a confirmation to the big address below — scroll up to fix any typos!
    {weGather}

  • Would you like to subscribe this address to email updates?
  • Last Step! Application Fee

  • Check one item below to pay the application fee:*

    prevnext( X )
    USA-Virtus Athlete Application Fee. From National review by AWL to Virtus confirmation. (required for U.S. Paralympics)
    USA-Virtus Athlete Application Fee

    From National review by AWL to Virtus confirmation.


    (required for U.S. Paralympics)

    $150$150
      
    Inspire League Soccer Eligibility. For players on Inspire League teams.
    Inspire League Soccer Eligibility

    For players on Inspire League teams. 

    $75$75
      
    Total
    $0.00$0.00
  • What is the correct billing address:*
  • Payment Methods

  • Should be Empty: