RISE 5v5 REGISTRATION

Player's Name *

First Name

Last Name

Birthdate *

MM

DD

YYYY

Parent or Legal Guardian Name *

First Name

Last Name

Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Phone *

(###)

###

####

Consent for Medical Treatment *

As parent or legal guardian of the above-named registrant, I hereby give my consent for emergency medical care prescribed by a duly licensed Doctor of Medicine or Doctor of Dentistry. This care may be given under whatever conditions are deemed necessary to preserve the life, limb, or well-being of the registrant

I Consent

I do NOT Consent

PARENT CODE OF CONDUCT *

This Parent Code of Conduct has been developed to clarify and define the standards of professional, ethical, and moral behavior from parents affiliated with the Utah Youth Soccer Association (UYSA). 1. I will emphasize that the game is played for fun, and for the benefit of the youth, not adults. 2. I will act as a role model by demonstrating positive support for all players, coaches, and game officials regardless of race, creed, color, gender, religion, or ability. 3. I will not engage in any kind of unsportsmanlike conduct with any official, coach, player, parent, or spectator such as booing and taunting, refusing to shake hands, or using profane language or gestures. 4. I will teach my child to play within the spirit and intentions of the rules and the Laws of the Game. 5. I will refrain from criticizing the game officials, and will respect their authority and decisions during games. 6. I will never place the value of winning over the safety and welfare of the players. 7. I will demand a sports environment free from drugs, tobacco, and alcohol and I will refrain from their use at all sporting events. 8. I will not encourage, invite, nor recruit any player from an opposing team to join my childs team during the playing season. I understand that if I fail to abide by the aforementioned UYSA Parent Code of Conduct, I will be subject to disciplinary action that could include, but is not limited to the following: Verbal warning by an official, team coach, and/or head of league organization Game forfeiture through an official or team coach Parental suspension with written documentation to be kept on file with UYSA I have read this UYSA Parent Code of Conduct. I understand its requirements and agree to abide by the letter and spirit of this UYSA Parent Code of Conduct

I have read and understand the Parent Code of Conduct and agree to the terms

PARTICIPATION RISK STATEMENT *

I, the undersigned am a parent or legal guardian of the named minor. I fully understand that participating in the sport of soccer presents a risk for serious injury and death. In my capacity as parent or legal guardian, I understand the risks and my responsibility to notify the other parent or legal guardians as well as the minor of the risks involved with sport participation. I have made a conscious decision to allow the named minor to play. I agree that my health and accident insurance will be the primary insurance to cover expenses for any such injury, including rehabilitation.

I accept the participation risk statement

PHOTO WAIVER *

I hereby permit and authorize the Utah Youth Soccer Association and its agents, sponsors and others acting on its behalf, to use, reproduce and/or publish photographs and/or video that may pertain to the registered child/children, including their image, likeness and/or voice, without compensation. I understand that this material may be used in various publications, public relations or marketing releases, recruiting materials or for other endeavors specifically related to promotion of the sport of soccer. This material may also appear on the Association’s internet website or Facebook page. Consequently, the Association may publish materials, use my child’s/childrens’ name, photograph and/or make reference to my child/children in any manner that the Association deems appropriate in order to promote or publicize itself and its endeavors in relation to growing the sport of soccer in the state of Utah and surrounding areas.

I accept the photo waiver

UYSA REFUND POLICY *

The UYSA registration fee and Legacy Fields Fee is not refundable. The state competition league fee is refundable before alignment for the season in which a refund is requested has taken place.

I understand the UYSA Refund Policy

TEXTING *

NUU has permission to text individuals about DESTINATION related information and NUU Club Soccer information

I give permission to receive texts from NUU

I do not give permission to receive texts