FREE PROTECTIVE Baseball and Softball Helmet Application

FREE
PROTECTIVE
Baseball and
Softball Helmet
Application
www.playhardgear.com
Ohio Ophthalmological Society
5115 Parkcenter Ave., Suite 200
Dublin, OH 43017-7553
F 614-527-6763
P 614-527-6799
www.playhardgear.com
Ohio Ophthalmological Society
5115 Parkcenter Ave., Suite 200
Dublin, OH 43017-7553
F 614-527-6763
P 614-527-6799
www.playhardgear.com
2016 Baseball & Softball
PARTICIPANT PACKET & APPLICATION
PROGRAM INFORMATION
page 1 of 6
About Sports Eye Safety
Baseball and softball are the number one cause of severe sports-related eye injuries in the United States. Eye injuries
are often the result of a high-speed ball, aggressive body contact, or a swinging/moving piece of sports equipment. Young
players often lack the reflexes, coordination, strength, or experience to avoid these eye hazards. For example, children often
misjudge balls in flight, causing them to take a blow to the face or head.
The result of eye injuries can be devastating. These injuries can cause loss of vision or the complete loss of an eye. Even
a minor injury can cause retinal detachment and blindness.
About the Play Hard. Don’t Blink. Program
The Ohio Ophthalmological Society’s (OOS) Play Hard. Don’t Blink. sports eye safety program works with organized Ohio
youth baseball and softball leagues to prevent eye injuries by donating batting helmets with protective face masks. Five
helmets are provided to each participating team. Helmets are one-size-fits-all and come in black. Helmets are manufactured
by Rawlings sporting goods and meet NOCSAE safety standards.
The Play Hard. Don’t Blink. program is funded through the Ohio Department of Health Save Our Sight program. Since the
program’s beginning in 1999, the OOS has donated more than 60,000 helmets to over 12,000 teams in Ohio. In the 2016
season, the OOS will be donating thousands more helmets to youth baseball and softball leagues in Ohio.
We try to serve as many leagues as possible and give careful consideration to each application we receive. Current
participating leagues applying for additional equipment to add teams or replace equipment through our program will be
served based on helmet availability. It is our hope that leagues that have already benefitted from our program will support
sports eye safety efforts by purchasing additional protective equipment through league funds.
How the Play Hard. Don’t Blink. Program Works
Please carefully review the program guidelines page of this packet for a complete summary of program guidelines and
criteria. Once your league has reviewed and agreed to the program guidelines, please submit your completed application
to the OOS at the address provided on the last page of this packet. All applications are reviewed in November and letters
of acceptance and denial are mailed in mid-December.
Unfortunately, due to the large amount of requests we receive for equipment, we are not able to fulfill all requests. IF YOU
DO NOT RECEIVE A LETTER OF ACCEPTANCE OR DENIAL FROM US BY JANUARY 1, 2016, PLEASE CONTACT OUR OFFICE
AT (614) 527-6799.
Important Dates to Remember
December 3, 2015: 2016 applications due to the OOS.
Mid-December 2015: Applications are reviewed and letters of program acceptance or denial
are mailed to leagues.
Mid-January 2016: Program materials (coaches pre- and post-season evaluations, program
video, etc.) are sent to the League Administrator at the League Administrator’s address provided.
Mid-December 2015:
to January 2016: Equipment orders are shipped directly to the shipping address provided.
April 29, 2016: All pre-season information including coaches pre-season evaluation and
the coaches roster information must be submitted. Each participating
coach must complete one pre-season questionnaire.
June 28, 2016: All post-season questionnaires are due. Each participating coach must
complete one post-season questionnaire.
Ohio Ophthalmological Society
5115 Parkcenter Ave., Suite 200
Dublin, OH 43017-7553
F 614-527-6763
P 614-527-6799
www.playhardgear.com
2016 Baseball & Softball
PARTICIPANT PACKET & APPLICATION
PROGRAM GUIDELINES
page 2 of 6
In order to participate in the Play Hard. Don't Blink. program, each participating
league MUST:
• Be an amateur boys baseball or girls softball league in the state of Ohio with players between the ages of 5 to 18.
• Mandate the use of the protective equipment while players bat and run the bases.
In order to participate in the Play Hard. Don't Blink. program, each participating
league administrator MUST:
• Accept overall responsibility for league adherence to program and use of protective equipment. Should League
Administrators change, it is the signing League Administrator's responsibility to notify us of the change and to inform
the successor of the responsibility to the program.
• Agree to supporting the Play Hard. Don't Blink. program and the importance of sports eye safety for young athletes.
• Provide a complete roster of participating team's coaches including; coaches name/home address/team name/players
age ranges/sex of players/number of children on team/and whether for baseball or softball. This is for our informational
purposes only, mailing lists will not be shared.
• Complete the administrator's pre-season questionnaire and information in the participant packet.
• League administrators are responsible for dispersing, collecting and returning all of the coaches pre- and post-season
evaluations. Pre-season coaches questionnaires are due NO LATER THAN APRIL 29th, 2016 AND MUST BE RECEIVED
FROM EACH PARTICIPATING COACH TO ENSURE DELIVERY OF EQUIPMENT. Post-season questionnaires are due NO
LATER THAN JUNE 28th, 2016 and MUST BE RECEIVED FROM EACH PARTICIPATING COACH.
• Agree to the possibility of having program representatives visit your league during the year.
• Place a minimum order for 60 pieces (12 teams). No individual orders will be accepted.
• Provide space for the protective helmets to be housed until the season begins. This space must be available Monday–Friday during the months of December and January from 9am–5pm with a person available to accept the delivery. Person
receiving the order will need to assist in unloading the 5 lb boxes from the delivery truck. We will try to notify you when
the delivery is scheduled, however, this is not always possible.
THIS IS A THREE-YEAR COMMITMENT.
Your league is agreeing to completing and returning the pre- and post-season evaluations for the next three
years in addition to abiding to the above. At the end of these three years, the equipment becomes property
of the participating league. In addition, your organization agrees to provide the educational materials to the
parents, players and coaches in your program.
If the participating league fails to submit information as requested, the league will be required to return
all equipment at their own expense to the Play Hard. Don't Blink. program.
Ohio Ophthalmological Society
5115 Parkcenter Ave., Suite 200
Dublin, OH 43017-7553
F 614-527-6763
P 614-527-6799
www.playhardgear.com
2016 Baseball & Softball
PARTICIPANT PACKET & APPLICATION
PROGRAM INFORMATION
page 3 of 6
All information MUST be completed for your application to be considered.
League Administrator Name and Title:
League Name:
League Administrator Address:
ADDRESS
Phone Number (day):
CITY
ZIP
Phone Number (evening):
COUNTY
Email Address:
Safety Officer Name:
Safety Officer Address:
ADDRESS
CITY
ZIP
COUNTY
Coaches Meeting Date:
Coaches Meeting Location:
Organized Youth League Name:
League Phone Number:
Organized Youth League Address:
ADDRESS
CITY
ZIP
COUNTY
Total Number of Teams in League:
Total Number of Children in League:
Age Ranges:
Playing Season Starts:
Playing Season Ends:
Sport the protective eyewear will be used for:
Boys Baseball
Type of children’s protective eyewear being ordered:
Girls Softball
Boys Batting Helmet
Girls Batting Helmet
Number of children that will be wearing the protective eyewear:
Number of teams wearing protective eyewear:
Sex of children wearing the protective eyewear:
Female
Ages of children wearing the protective eyewear:
Male
5-7
6-8
9-11
Has your league ever applied to the Play Hard. Don’t Blink. baseball or softball program?
If yes, what year?
12-14
Yes
No
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
2013
2014
2015
Was your league accepted into the Play Hard. Don’t Blink. baseball or softball program?
Yes
15-18
No
If yes, how many teams currently participate in the program?
How did you hear about our program?
Brochure
Other (specify)
Mailing
Parent
Program web site
Player
Coach
Television
Newsletter
Ohio Department of Health/Save Our Sight web site
Ohio Ophthalmological Society
5115 Parkcenter Ave., Suite 200
Dublin, OH 43017-7553
F 614-527-6763
P 614-527-6799
www.playhardgear.com
2016 Baseball & Softball
PARTICIPANT PACKET & APPLICATION
PROGRAM PARTICIPANT QUESTIONNAIRE
page 4 of 6
All information MUST be completed for your application to be considered.
Will you or your youth league be mandating the use of the
children’s protective eyewear while they are playing?
Yes
What was the greatest force in your league's decision to use
the protective equipment?
Concern for player's safety
Liability
Parental pressure
Donation of equipment through this program
Did the Play Hard. Don’t Blink. program make the protective
eyewear more accessible for your team/league?
Yes, we couldn’t find the equipment anywhere else
Somewhat, we could have ordered elsewhere but
this was the easiest way
Not really
What role did the donation of the equipment through the
Play Hard. Don’t Blink. program play in the decision to use
protective eyewear?
STRONG- Without the donation our team/league
would not have purchased the protective eyewear
It helped somewhat
It was not a factor in our decision
How important do you think this kind of protection is?
Please rate importance:
Extremely Important
Somewhat Important
Not Important
Do you feel the protective eyewear will make a difference
in protecting your players vision on the field?
Yes
Please rate how difficult you think it will be to get your league
to wear the protective helmets? Please rate difficulty:
Not difficult at all
Somewhat difficult
Extremely difficult
Do you believe the use of protective eyewear will enhance
or inhibit your players performance?
Enhance
Inhibit
Before learning about the Play Hard. Don’t Blink. program,
were you aware of the types of sports protective eyewear
that is available?
Yes
What were the key variables in your league’s decision to use
the protective helmets?
Mandated by league
I want to provide safest equipment available
for my team/league
Helmets free of cost
Parents requested
Children requested
Does your league currently have a written policy regarding
protective eyewear?
If you answered yes, would you please share with us that policy?
Yes
The Play Hard. Don't Blink. program is funded through the Ohio
Department of Health's (ODH) Save Our Sight fund. In order to
monitor our program's effectiveness in serving large and
diverse numbers of children throughout Ohio, ODH has asked
that applicants provide information about the children who will
be benefiting form the use of the equipment. Please complete
the following information to the best of your ability:
Percentage of children served:
% African American/Black
% American Indian/Alaska Native
% Asian/Pacific Islander
% Hispanic or Latino
% White
Comments:
No
No
Undecided
No
No
Ohio Ophthalmological Society
5115 Parkcenter Ave., Suite 200
Dublin, OH 43017-7553
F 614-527-6763
P 614-527-6799
www.playhardgear.com
2016 Baseball & Softball
PARTICIPANT PACKET & APPLICATION
PROGRAM PARTICIPANT ORDER FORM
page 5 of 6
All information MUST be completed for your application to be considered.
All orders must be received by December 3, 201 5. Minimum order is sixty pieces (five pieces per each of twelve teams).
No individual orders are accepted.
The following information from this packet must be submitted with order:
• program participant information
• program participant questionnaire
• program participant order form
• signed program participant agreement form
All pre-season information including the coaches pre-season evaluation and the coaches roster information must be
submitted on or before April 29th 2016 or the equipment order will not be shipped.
NOCSAE approved Rawlings Baseball Helmet
NOCSAE approved Rawlings Softball Helmet
• Lightweight helmet design
including wire face mask
• Lightweight helmet design
including wire face mask
• One-size-fits-all
• One-size-fits-all
• Helps prevent facial,
dental and eye injuries
while building confidence
in players
• Helps prevent facial,
dental and eye injuries
while building confidence
in players
• All face masks are black
• All face masks are black
Calculation: Number of baseball teams participating
x 5 helmets per team.
Calculation: Number of softball teams participating
x 5 helmets per team.
Total Baseball Hemets Requested: #
Total Softball Hemets Requested: #
Location for Shipment:
Please provide a location for shipment delivery that will have a person available to receive the order. Once you are accepted
into the program and your order is placed we are unfortunately not able to change the shipping address.
Contact Name for Individual Receiving Equipment:
Address (NO P.O. BOXES):
ADDRESS
Phone Number (day):
Email Address:
Date order is needed:
CITY
Phone Number (evening)
ZIP
Ohio Ophthalmological Society
5115 Parkcenter Ave., Suite 200
Dublin, OH 43017-7553
F 614-527-6763
P 614-527-6799
www.playhardgear.com
2016 Baseball & Softball
PARTICIPANT PACKET & APPLICATION
PROGRAM PARTICIPANT AGREEMENT
page 6 of 6
All information MUST be completed for your application to be considered.
By signing below, you and your league agree to be a part of the Ohio Ophthalmological Society’s Play Hard. Don’t Blink.
sports eye safety program. In exchange for the protective equipment, you and your league agree to abide by the program
participant guidelines outlined in this packet. This requires the league administrator to provide a complete roster of participating team’s coaches information, completing the administrator’s pre- and post-season questionnaire and information in
the participant packet as well as dispersing, collecting and returning all the coaches pre- and post-season evaluations.
THIS IS A THREE-YEAR COMMITMENT.
If the participating league fails to submit information as requested, the league will be required to return all the equipment
at their own expense to the Play Hard. Don’t Blink. program.
Signature:
Date:
Print Name:
Your league will be notified as to the status of your application by mid-December 2015. The letter of acceptance or
denial will be sent to the league administrator’s address provided. If your league does not receive this mailing please contact
us directly.
Please send your completed application via mail to:
Ohio Ophthalmological Society
5115 Parkcenter Ave., Suite 200
Dublin, OH 43017-7553
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