Soccer and basketball
goggles application

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League Administrator

Numbers only. Include area code.

Numbers only. Include area code.

Safety Officer
Coaches Meeting
Organized Youth League

Numbers only. Include area code.

League Information

A minimum of 12 teams are required in order to participate in this program.

The Superspecs and Play Hard. Don’t Blink. programs are 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 from the use of the equipment. Please complete the following information to the best of your ability.

Percentage of children served:
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.

No P.O. Boxes


This is a three-year commitment

By typing your name 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.

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 Superspecs program.
Superspecs and Play Hard. Don’t Blink. are funded by a grant awarded by the Ohio Department of Health, Bureau of Maternal and Child Health Save Our Sight Fund. For more information about the Save Our Sight Fund and how you can help promote good eye health and safety for children in Ohio, visit: