This registration session will allow you to complete contact information, sign up for participation, and submit payment. Please read through each page carefully to ensure all information is provided accurately.

Please direct questions to Cheyenne Streff, Executive Director
Phone: (414) 310-7051    Email: cheyennestreff@WASA.org

Do you qualify or currently receive assistance from a state or federal financial assistance program?:

CONCUSSION PROTOCOL

WHAT IS A CONCUSSION?

A concussion is a type of traumatic brain injury—or TBI—caused by a bump, blow, or jolt to the head or by a hit to the body that causes the head and brain to move quickly back and forth. This fast movement can cause the brain to bounce around or twist in the skull, creating chemical changes in the brain and sometimes stretching and damaging the brain cells.

HOW CAN I SPOT A POSSIBLE CONCUSSION?

Athletes who show or report one or more of the signs and symptoms listed below—or simply say they just “don’t feel right” after a bump, blow, or jolt to the head or body—may have a concussion or other serious brain injury.

Signs Observed by Others

• Appears dazed or stunned.
• Forgets an instruction, is confused about an assignment or position, or is unsure of the game, score, or opponent.
• Moves clumsily.
• Answers questions slowly.
• Loses consciousness (even briefly).
• Shows mood, behavior, or personality changes.
• Can’t recall events prior to or after a hit or fall.

Symptoms Reported by Athletes

• Headache or “pressure” in head.
• Nausea or vomiting.
• Balance problems or dizziness, or double or blurry vision.
• Bothered by light or noise.
• Feeling sluggish, hazy, foggy, or groggy.
• Confusion, or concentration or memory problems.
• Just not “feeling right,” or “feeling down

DISCUSS CONCUSSIONS WITH YOUR TEAM

Tell other athletes to report their concussion symptoms to your coach right away. Some athletes think concussions aren’t serious or worry that if they report a concussion they will lose their position on the team or look weak. Be sure to remind them that it’s better to miss one game than the whole season.

CONCUSSIONS AFFECT EACH INDIVIDUAL DIFFERENTLY

While most individuals with a concussion feel better within a couple of weeks, some will have symptoms for months or longer. Talk with your health care provider if concussion symptoms do not go away or if they get worse after individuals return to regular activities.

WHAT ARE SOME MORE SERIOUS DANGER SIGNS TO LOOK OUT FOR?

In rare cases, a dangerous collection of blood (hematoma) may form on the brain after a bump, blow, or jolt to the head or body and can squeeze the brain against the skull. Call 9-1-1 or take the athlete to the emergency department right away if, after a bump, blow, or jolt to the head or body, he or she has one or more of these danger signs:

• One pupil larger than the other.
• Drowsiness or inability to wake up.
• A headache that gets worse and does not go away.
• Slurred speech, weakness, numbness, or decreased coordination.
• Repeated vomiting or nausea, convulsions or seizures (shaking or twitching).
• Unusual behavior, increased confusion, restlessness, or agitation.
• Loss of consciousness (passed out/knocked out). Even a brief loss of consciousness should be taken seriously.

WHAT SHOULD I DO IF I SUSPECT A POSSIBLE CONCUSSION? YOU SHOULD:

1. Remove the athlete from play.
2. Keep athlete out of gameplay/practice the day of the injury. The athlete should be seen by a health care provider and only return to gameplay/practice with permission from a health care provider who is experienced in evaluating for concussion.
3. Ask the health care provider for written instructions on helping an athlete return to gameplay/practice. You can give the instructions to the athlete and return-to-play instructions to the coach and/or athletic trainer.

Do not try to judge the severity of the injury yourself. Only a health care provider should assess an individual for a possible concussion. Concussion signs and symptoms often show up soon after the injury. But you may not know how serious the concussion is at first, and some symptoms may not show up for hours or days. The brain needs time to heal after a concussion. An individual's return to sports should be a gradual process that is carefully managed and monitored by a health care provider.

To learn more, go to www.cdc.gov/HEADSUP 

 Parent Athlete Fact Sheet

 Fact Sheet for Athletes

I have read the above information about concussions and understand the contents.  I have spoken with my coach and/or parent (if under 18yo) about what to do if I have a concussion or some other serious brain injury. 

PARTICIPANT WAIVER AND RELEASE OF LIABILITY

WAIVER AND RELEASE OF LIABILITY

IN CONSIDERATION OF the risk of injury that exists while participating in WASA Programs (hereinafter the "Activity"); and

IN CONSIDERATION OF my desire to participate in said Activity and being given the right to participate in same;

I HEREBY, for myself, my heirs, executors, administrators, assigns, or personal representatives (hereinafter collectively, "Releasor," "I" or "me", which terms shall also include Releasor's parents or guardian if Releasor is under 18 years of age), knowingly and voluntarily enter into this WAIVER AND RELEASE OF LIABILITY and hereby waive any and all rights, claims or causes of action of any kind arising out of my participation in the Activity; and

I HEREBY release and forever discharge WISCONSIN ADAPTIVE SPORTS ASSOCIATION, located at 715 Talon Trail, Brookfield, Wisconsin 53045, their affiliates, managers, members, agents, attorneys, staff, volunteers, heirs, representatives, predecessors, successors and assigns (collectively "Releasees"), from any physical or psychological injury that I may suffer as a direct result of my participation in the aforementioned Activity. 

I AM VOLUNTARILY PARTICIPATING IN THE AFOREMENTIONED ACTIVITY AND I AM PARTICIPATING IN THE ACTIVITY ENTIRELY AT MY OWN RISK. I AM AWARE OF THE RISKS ASSOCIATED WITH PARTICIPATING IN THIS ACTIVITY, WHICH MAY INCLUDE, BUT ARE NOT LIMITED TO: PHYSICAL OR PSYCHOLOGICAL INJURY, PAIN, SUFFERING, ILLNESS, DISFIGUREMENT, TEMPORARY OR PERMANENT DISABILITY (INCLUDING PARALYSIS), ECONOMIC OR EMOTIONAL LOSS, AND DEATH. I UNDERSTAND THAT THESE INJURIES OR OUTCOMES MAY ARISE FROM MY OWN OR OTHERS' NEGLIGENCE, CONDITIONS RELATED TO TRAVEL TO AND FROM THE ACTIVITY, OR FROM CONDITIONS AT THE ACTIVITY LOCATION(S). NONETHELESS, I ASSUME ALL RELATED RISKS, BOTH KNOWN AND UNKNOWN TO ME, OF MY PARTICIPATION IN THIS ACTIVITY.

I FURTHER AGREE to indemnify, defend and hold harmless the Releasees against any and all claims, suits or actions of any kind whatsoever for liability, damages, compensation or otherwise brought by me or anyone on my behalf, including attorney's fees and any related costs.

I FURTHER ACKNOWLEDGE that Releasees are not responsible for errors, omissions, acts or failures to act of any party or entity conducting a specific event or activity on behalf of Releasees. In the event that I should require medical care or treatment, I authorize Wisconsin Adaptive Sports Association to provide all emergency medical care deemed necessary, including but not limited to, first aid, CPR, the use of AEDs, emergency medical transport, and sharing of medical information with medical personnel. I further agree to assume all costs involved and agree to be financially responsible for any costs incurred as a result of such treatment. I am aware and understand that I should carry my own health insurance.

I FURTHER ACKNOWLEDGE that this Activity may involve a test of a person's physical and mental limits and may carry with it the potential for death, serious injury, and property loss. I agree not to participate in the Activity unless I am medically able and properly trained, and I agree to abide by the decision of the Wisconsin Adaptive Sports Association official or agent, regarding my approval to participate in the Activity. 

I HEREBY ACKNOWLEDGE THAT I HAVE CAREFULLY READ THIS "WAIVER AND RELEASE" AND FULLY UNDERSTAND THAT IT IS A RELEASE OF LIABILITY. I EXPRESSLY AGREE TO RELEASE AND DISCHARGE Wisconsin Adaptive Sports Association AND ALL OF ITS AFFILIATES, MANAGERS, MEMBERS, AGENTS, ATTORNEYS, STAFF, VOLUNTEERS, HEIRS, REPRESENTATIVES, PREDECESSORS, SUCCESSORS AND ASSIGNS, FROM ANY AND ALL CLAIMS OR CAUSES OF ACTION AND I AGREE TO VOLUNTARILY GIVE UP OR WAIVE ANY RIGHT THAT I OTHERWISE HAVE TO BRING A LEGAL ACTION AGAINST Wisconsin Adaptive Sports Association FOR PERSONAL INJURY OR PROPERTY DAMAGE.

To the extent that statute or case law does not prohibit releases for ordinary negligence, this release is also for such negligence on the part of Wisconsin Adaptive Sports Association, its agents, and employees.

I agree that this Release shall be governed for all purposes by Wisconsin law, without regard to any conflict of law principles. This Release supersedes any and all previous oral or written promises or other agreements.

In the event that any damage to equipment or facilities occurs as a result of my or my family's or my agent's willful actions, neglect or recklessness, I acknowledge and agree to be held liable for any and all costs associated with any such actions of neglect or recklessness.

THIS WAIVER AND RELEASE OF LIABILITY SHALL REMAIN IN EFFECT FOR THE DURATION OF MY PARTICIPATION IN THE ACTIVITY, DURING THIS INITIAL AND ALL SUBSEQUENT EVENTS OF PARTICIPATION.

THIS AGREEMENT was entered into at arm's-length, without duress or coercion, and is to be interpreted as an agreement between two parties of equal bargaining strength. Both myself and the Wisconsin Adaptive Sports Association agree that this agreement is clear and unambiguous as to its terms, and that no other evidence shall be used or admitted to alter or explain the terms of this agreement, but that it will be interpreted based on the language in accordance with the purposes for which it is entered into.

In the event that any provision contained within this Release of Liability shall be deemed to be severable or invalid, or if any term, condition, phrase or portion of this agreement shall be determined to be unlawful or otherwise unenforceable, the remainder of this agreement shall remain in full force and effect. If a court should find that any provision of this agreement to be invalid or unenforceable, but that by limiting said provision it would become valid and enforceable, then said provision shall be deemed to be written, construed and enforced as so limited. 

I, THE UNDERSIGNED PARTICIPANT, AFFIRM THAT I AM OF THE AGE OF 18 YEARS OR OLDER, AND THAT I AM FREELY SIGNING THIS AGREEMENT. I CERTIFY THAT I HAVE READ THIS AGREEMENT, THAT I FULLY UNDERSTAND ITS CONTENT AND THAT THIS RELEASE CANNOT BE MODIFIED ORALLY. I AM AWARE THAT THIS IS A RELEASE OF LIABILITY AND A CONTRACT AND THAT I AM SIGNING IT OF MY OWN FREE WILL. I have read this entire Release. I fully understand the entire Release and acknowledge that I have had the opportunity to review this Release with an attorney of my choosing if I so desire, and I agree to be legally bound by the Release.

THIS IS A RELEASE OF YOUR RIGHTS. READ CAREFULLY AND UNDERSTAND BEFORE SIGNING.

I fully understand and agree to the terms of this agreement.

WASA CODE OF CONDUCT

The Wisconsin Adaptive Sports Association (WASA) promotes sportsmanlike conduct consistent with safe, fair-play and responsible conduct under the umbrella of governance of adaptive sports and recreational activities. In order to achieve this goal, WASA holds accountable these individuals and/or groups to conduct themselves in a manner of the highest standards of moral and ethical behavior: WASA Athletes, team coaches, team staffs, team representatives, league leadership, medical personnel, volunteers, parents/guardians, spectators, tournament officials/staff, tournament host staff, sponsors and any additional affiliates contracted by the local teams, or tournament hosts. This level of accountability should apply to: Practices, tournaments, demonstrations, and any other events that, in the eyes of the WASA Board of Directors, represents WASA or adaptive sports in the United States, whether it occurs in a domestic or international location. This accountability starts once the individual is on the indoor/outdoor premises of the event, including parking lots, parks, paths or other private/public areas surrounding the event, or during travel to/from an international event or during their stay during an international event. 

The Code of Conduct requires that aforementioned parties:

1. Act in a sportsmanlike manner consistent with the spirit of safe, fair play and responsible conduct, physically, emotionally, and verbally
2. Refrain from restricting the ability of another competition-eligible individual to play adaptive sports
3. Respect the rights of all individuals to fair treatment and equal opportunity, free from discrimination or harassment of any type, including without limitation discrimination on the basis of race, color, religion, sex, sexual orientation, age, national origin, disability, or otherwise
4. Know, understand, adhere to and comply with all applicable state and federal laws
5. Respect the property of others, including WASA equipment, whether personal or public
6. Respect all adaptive sport-affiliated individuals previously mentioned on and off the court

A violation of the Code of Conduct may or may not result in a warning, and may result in sanctions against the individual or group, including, but is not limited to: Removal from competition, suspension, or expulsion from the WASA. A violation should be reported to the Program Director of WASA for review, and there is no statute of limitations concerning the reporting of a Code of Conduct violation. The Program Director will consider the report of the violation, investigate the violation and render a decision to the appropriate parties. An appeal of the decision can be filed within (14) days of the decision to the WASA Board of Directors, excluding the Program Director. The WASA Board of Directors will have an additional (30) days to investigate and render a decision. If no Program Director position is currently filled, report violation to a WASA Board Officer.

In the case of a Code of Conduct violation by a member of the WASA Board of Directors, the remaining members, excluding the individual(s) being investigated will conduct an investigation into the violation and render a decision by simple majority within 30 days. Any decision rendered by the WASA Board of Directors is final. 

I fully understand and agree to the terms of this agreement.

TRAVEL REIMBURSEMENT AGREEMENT

WASA will provide travel reimbursements based on available funds. Each Sport Program will have a specific travel reimbursement policy and season budget. All travel reimbursement MUST be pre-approved by the WASA Board of Directors prior to travel or event (2 weeks minimum notice).

​To qualify for travel reimbursement WASA adult athletes must:

• Pay WASA and Sport Fee
• Participate in Fundraising (letter Campaign, Sponsorship, United Way Giving etc.)
• Volunteer 6 Hours at  WASA events (Big Cheese, Fundraisers, Demo’s/TryIt's, etc.)
• Apply for a Grant Request (CAF, D4I, Kelly Brush etc.) and/or Find Tournament Sponsorships 

WASA will provide the tools to help each athlete be successful with fundraising and grant writing upon request. There is an incentive program to earn more money toward individual travel reimbursement.

WASA Fundraising Incentive Plan

WASA athletes have an opportunity to increase their allowable travel reimbursement allotment through individual fundraising. Individual fundraising opportunities include personal campaign letters, direction of United Way Funds, School demonstrations, Corporate Sponsorships for events, any other fundraising ideas you are willing to coordinate and volunteer. WASA administrators will support all fundraising efforts pending schedule availability. Samples of fundraising letter campaigns are available as well.

MEDIA/PHOTO CONSENT

I, the undersigned, hereby consent and give permission to Wisconsin Adaptive Sports Association (WASA) and the above-named event sponsoring organizations), to take still photographs, video / film recording and audio-recording.

In addition, I hereby consent and give permission to WASA to use and/or disclose such still photographs, video/film recordings and audio recordings for publication in newspapers, trade journals and other publications as well as broadcast via radio or television. This release is good for one year from the date signed.

WASA YEARLY FEE $50

Instructions: The yearly WASA fee is $50 and is required once per year regardless of the number of sports you participate in. If you have already paid this fee this year, you do not need to pay it again.  The WASA program year runs from August to July. 

Annual Registration Fee: $50
Fee is waived for Veterans.

COMPETITION & TRAVEL PROGRAMS: PRIMARY SPORT

If you are participating in competitions and travel for one of the following sports, select it.

Fee: $200

Veterans Participate for Free

RECREATION-ONLY PROGRAM FEES

If you are only participating in recreational sports (no competitions or travel), select each sport here.

Fees: $50 for each sport checked

Veterans Participate for Free. 

SECTION 6: TRYIT EXPERIENCE

Instructions: If you are new to WASA or adaptive sports and want to try some activities, please check the sport(s) you will participate in below. There is no additional fee beyond your annual WASA membership. Option is only good for 1 WASA calendar year (September-August). Participants will be expected to pay the recreation fee/competitive fees if desiring to continue the sport(s) the next season.