Your Name *

Your Email *

Manager Name *

Manager Email *

Manager Phone Number *

Team Name *

Division of Play *

Identify the impairment(s) for which you are requesting accommodation(s) and the expected duration of the impairment(s). *

Explain how the impairment(s) affects your ability to participate in softball play in accordance with the rules as prescribed in the current ASANA Softball code or USA Softball rules. *

What specific accommodations are you requesting? *

Has a physician, vocational rehabilitation specialist or other health professional recommended a specific accommodation? *

If a physician, vocational rehabilitation specialist or other health professional recommended a specific accommodation please describe. *

Provide any additional information that may be helpful in reviewing your accommodation request(s). You may also email any supporting documentation directly to commissioner@surfandsunsoftball.com. *

Medical Documentation is Required to fulfill your ADA request. Please email documentation from your provider to commissioner@surfandsunsoftball.com *

I understand and will email my supporting medical documentation to commissioner@surfandsunsoftball.com

Thank you for letting us know of your ADA needs.

We will follow up with your team manager with any necessary documentation.

Please verify that you are a human.