DCFC Youth Player Contract May 23, 2020June 1, 2020 by Celtic DCFCYouthPacket Membership and Contracts Player Printed Name: * Player's Birth date: * Parent/Guardian Printed Name: * I Voluntarily commit my son/daughter to play for * DCFC Youth West for the 2020/2021 seasonal soccer year. DCFC Youth Genesee for the 2020/2021 seasonal soccer year. DCFC Youth Downriver for the 2020/2021 seasonal soccer year. DCFC Youth City for the 2020/2021 seasonal soccer year. DCFC Youth Membership Agreement I have NOT signed with any other club and/or team for this seasonal year. I understand that signing this form binds me to the DCFC Youth for the entire seasonal year (both fall and spring) unless a release or transfer application is granted by DCFC Youth and MSYSA. I understand that the fees must be paid in full as detailed in the payment plan in the tryout brochure and that failure to pay program fees will result in suspension of membership and the player will not be able to participate until paid. If my player(s) drops out of DCFC Youth for any reason, or is/are suspended from the club for violation of this agreement or any other documented club rules and regulations, I understand that I am not entitled to a refund of any kind and will remain responsible to the entire year’s costs. If I default on payment of DCFC Youth yearly fees, I am liable for the costs involved in collecting those fees. This includes but is not limited to attorney fees and collection fees. I hereby grant and authorize DCFC Youth the right to take, edit, alter, copy, exhibit, publish, distribute and make use of any and all pictures or video taken of me or my player to be used in and/or for legally promotional materials including, but not limited to, newsletters, flyers, posters, brochures, advertisements, fundraising letters, annual reports, press kits and submissions to journalists, websites, social networking sites and other print and digital communications, without payment or any other consideration. This authorization extends to all languages, media, formats and markets now known or hereafter devised. This authorization shall continue indefinitely, unless I otherwise revoke said authorization in writing. I have read, understand and agree to the above Membership Agreement * Yes ATHLETIC PARTICIPATION WAIVER It is the purpose of this agreement to exempt, waive and relieve releases from liability for personal injury, property damage, and wrongful death, including if caused by negligence, including the negligence, in any, of releases. 'Releases' include DCFC Youth affiliates, member teams, event hosts, other participants, coaches, officials, sponsors, advertisers, and each of them, their officers, directors, agents and employees. By registering for tryouts, the participant (and participant’s parent(s)/guardian(s), if applicable) waive, release and relinquish any and all claims for liability and causes(s) of action, including for personal injury, property damage or wrongful death occurring to participant, arising out of participation in club events, member team activities, the sport of soccer, and/or activities incidental thereto, whenever or however they occur and for such period said activities may continue, and by this agreement and such claims, rights, and causes of action that participant (and participant’s parent(s)/guardian(s), if applicable) may have are hereby waived, released and relinquished, and participant (and participant’s parent(s)/guardian(s), if applicable) does(do) so on behalf of my/our and participant’s heirs, executors, administrative and assigns. In addition, the participant (and participant’s parent(s)/guardian(s), if applicable) does not provide primary medical insurance coverage and that the participant (and participant’s parent(s)/guardian(s), if applicable) in DCFC Youth, must provide personal medical insurance. In the case of injury or medical emergency and in the event participant, or their parent or guardian, cannot respond at the time of the emergency, DCFC Youth has permission to seek, administer, or have administered whatever first aid or emergency medical care deemed necessary for participant’s welfare, and it is understood that participant, and not DCFC Youth, shall be responsible for any and all charges for such health care services regardless of whether participant’s medical insurance would cover such charges. Furthermore, the participant (and participant’s parent(s)/guardian(s), if applicable) recognize that soccer has a certain degree of risk, and knowingly and voluntarily assume the risk of any injuries, or illness, regardless of severity, including death, and all risk of damage to or loss of property which may incur, even if arising from the negligence of DCFC Youth, while participating in the sport of soccer. By registering for tryouts, the participant (and participant’s parent(s)/guardian(s), if applicable) certify that there are no medical reasons why the participant cannot safely participate in DCFC Youth activities and agree to abide by all DCFC Youth policies. I have read, understand and agree to the above Athletic Participation Waiver * Yes General These are primary conduct guidelines of DCFC Youth. These guidelines cannot possibly cover every situation that will arise over the course of a season, and under certain situations, exceptions can be made according to the best judgment of the head coach. Please keep in mind, however, that the head coach is responsible to the entire team, player families, and the respective DCFC Youth soccer program. All decisions will be made with those obligations in mind. DCFC Youth expects all participants to maintain a high standard of conduct at all times and will enforce the standard firmly and fairly. If and when violations occur, the violator will receive disciplinary action from DCFC Youth according to its rules and policies. Standards of Conduct Be a good sport, whether you win or lose! Show a positive attitude toward your teammates, your coaches, game officials and people watching the game. Respect the people you play against and exhibit good sportsmanship. Follow the rules and expectations set by your team, league and or club. <Attend all team events and support your team at all times. All players are responsible and required to have appropriate uniforms and equipment according to club standard. Respect for property of others, adherence to the rules and guidelines as specified here or by the Coach/Administrator and observance of State and Federal laws are required for participation in the program. Substance use and/or possession thereof (drugs, alcohol, marijuana/THC products, vape products, and/or tobacco) is cause for immediate dismissal from the program. Irresponsible and disrespectful behavior is cause for dismissal from DCFC Youth. Destruction of property or violation of State and Federal laws is cause for dismissal from the program. Failure to comply with any and all of these standards or team rules may be cause for disciplinary action. Persistent failure will be cause for dismissal from DCFC Youth. I have read, understand and agree to the above Player Code of Conduct * Yes Signature of Player confirming agreement and understanding of above * Clear Date Signed * PARENT CODE OF CONDUCT These are the primary conduct guidelines of DCFC Youth. These guidelines cannot possibly cover every situation that will arise over the course of a season, and under certain situations, exceptions can be made according to the best judgment of the head coach. Please keep in mind, however, that the head coach is responsible for the entire team, players, families, and the DCFC soccer program. All decisions will be made with these obligations in mind. DCFC Youth expects all parents to maintain a high standard of conduct at all times and will enforce the standard firmly and fairly. If and wahen violations occur, the violator will receive disciplinary action from DCFC Youth according to its rules and policies. Code of Conduct Set a good example, win or lose! All children are watching; make sure you have a positive attitude toward players, coaches, officials, and spectators. It is crucial that coaches are the only ones providing instruction to players. Refrain from yelling at anyone, especially the referee. Respect the opponent players, coach, game officials, families, and all spectators. Support your son/daughter and the team by following the rules regarding equipment, practices and games. Players should arrive on time and should be physically and mentally prepared to play. If a problem exists with a coach or manager follow these steps: Wait 24 hours. Contact and arrange a meeting with the coach – if that fails: Contact your Director of Coaching (Boys or Girls) – if that fails: Contact the Club Director – if that fails: <Contact a board member Regardless of who is contacted, we require a 24-hour quiet period after the game/training before making contact. A parent that has feedback in regard to any DCFC Youth function (tournament, league, organization) should communicate through the team’s head coach. All parents must follow club social media policy which prohibits any posts that disparage the club including its players and members, or competitors in/on any social media forum. Parents who fail to comply with the Code of Conduct will be subject to a meeting with the staff to determine the actions required, including, but not limited to removal from DCFC Youth. Failure to comply with any and all of these standards or team rules may be cause for disciplinary action. Persistent failure will be cause for dismissal from DCFC Youth. I have read, understand and agree to the above Parent Code of Conduct * Yes Signature of Parent confirming understanding and agreement of above * Clear Date Signed * COVID-19 Waiver Michigan State Youth Soccer Association RELEASE OF LIABILITY FOR YOUTH SOCCER - PLEASE READ BEFORE SIGNINGIN CONSIDERATION OF the child/adult named below being permitted to participate in activities and events under thejurisdiction of the Michigan State Youth Soccer Association (MSYSA), the undersigned acknowledges, understands, andagrees to the following: The risk of injury and/or illness from activities involved in youth soccer is significant, including the potential for permanent paralysis and death; while particular rules, equipment, and personal discipline may reduce the risk, the risk of serious injury does exist. The risk to have direct or indirect contact with individuals who have been exposed to or diagnosed with a communicable disease, including but not limited to COVID-19 or other medical conditions, diseases, maladies, or variations thereof, does exist and it is impossible to eliminate the risk that this child/adult could become infected through contact with or close proximity to an individual with a communicable disease. I KNOWINGLY AND FREELY ASSUME ALL SUCH RISKS, both known and unknown, and assume full responsibility for this child/adult’s participation in youth soccer. I willingly agree to comply with the stated and customary terms and conditions for participation. If, however, I observe any unusual, significant hazard during my presence at activities and/or events under the jurisdiction of the MSYSA, this child/adult will discontinue participation and bring such hazard to the attention of the nearest official immediately. This child/adult, and on behalf of my/our heirs, assigns, personal representatives, and next of kin, HEREBY RELEASE AND HOLD HARMLESS Michigan State Youth Soccer Association, their officers, officials, agents, employees, volunteers, other participants, sponsoring agencies, sponsors, advertisers, and if applicable, owners and lessors of premises used to conduct the events (“RELEASEES”), WITH RESPECT TO ANY AND ALL ILLNESS, DISABILITY, DEATH, or loss or damage to person or property, to this child/adult, to the fullest extent permitted by law I HAVE READ THIS RELEASE OF LIABILITY AND ASSUMPTION OF RISK AGREEMENT, FULLY UNDERSTAND ITS TERMS, UNDERSTAND THAT I HAVE GIVEN UP SUBSTANTIAL RIGHTS BY SIGNING IT, AND SIGN IT FREELY AND VOLUNTARILY WITHOUT ANY INDUCEMENT. Signature of Participant (player): * Clear Date Signed * FOR PARENT(S) OR GUARDIANS OF MINORITY AGE YOUTH PARTICIPANTS This is to certify that I, as parent/guardian, with legal responsibility for this participant, have read and explained the provisions in this waiver/release to my child/ward including the risks of presence and participation and his/her personal responsibilities for adhering to the rules and regulations for protection against injuries and illnesses (including communicable diseases). Furthermore, my/our child/ward understands and accepts these risks and responsibilities. I for myself, the other parent, and child/ward do consent and agree to his/her release provided above for all the Releasees. I, the other parent, and my/our child/ward do release and agree to indemnify and hold harmless the Releasees for any and all liabilities incident to my/our minor child’s/ward’s presence or participation in youth soccer activities as provided above, to the fullest extent provided by law. Signature of Parent/Guardian Clear Date Signed * (This release/waiver is in compliance with MCL 700.5109) Concussion (scroll to the bottom) WHAT IS A CONCUSSION? A concussion is a type of traumatic brain injury that changes the way the brain normally works. A concussion is caused by a bump, blow, or jolt to the head or body that causes the head and brain to move quickly back and forth. Even a “ding,” “getting your bell rung,” or what seems to be a mild bump or blow to the head can be serious. WHAT ARE THE SIGNS AND SYMPTOMS OF CONCUSSION? Signs and symptoms of concussion can show up right after the injury or may not appear or be noticed until days or weeks after the injury. If an athlete reports one or more symptoms of concussion after a bump, blow, or jolt to the head or body, s/he should be kept out of play the day of the injury. The athlete should only return to play with permission from a health care professional experienced in evaluating for concussion. DID YOU KNOW? • Most concussions occur without loss of consciousness.• Athletes who have, at any point in their lives, had a concussion have an increased risk for another concussion.• Young children and teens are more likely to get a concussion and take longer to recover than adults. SYMPTOMS REPORTED BY ATHLETE: • Headache or “pressure” in head• Nausea or vomiting• Balance problems or dizziness• Double or blurry vision• Sensitivity to light• Sensitivity to noise• Feeling sluggish, hazy, foggy, or groggy• Concentration or memory problems• Confusion• Just not “feeling right” or is “feeling down” SIGNS OBSERVED BY COACHING STAFF: • Appears dazed or stunned• Is confused about assignment or position• Forgets an instruction• Is unsure of 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 hit or fall• Can’t recall events after hit or fall “IT’S BETTER TO MISS ONE GAME THAN THE WHOLE SEASON” CONCUSSION DANGER SIGNS In rare cases, a dangerous blood clot may form on the brain in a person with a concussion and crowd the brain against the skull. An athlete should receive immediate medical attention if after a bump, blow, or jolt to the head or body s/he exhibits any of the following danger signs: • One pupil larger than the other• Is drowsy or cannot be awakened• A headache that gets worse• Weakness, numbness, or decreased coordination• Repeated vomiting or nausea• Slurred speech• Convulsions or seizures• Cannot recognize people or places• Becomes increasingly confused, restless, or agitated• Has unusual behavior• Loses consciousness (even a brief loss of consciousness should be taken seriously) WHAT SHOULD YOU DO IF YOU THINK YOUR ATHLETE HAS A CONCUSSION? 1. If you suspect that an athlete has a concussion, remove the athlete from play and seek medical attention. Do not try to judge the severity of the injury yourself. Keep the athlete out of play the day of the injury and until a health care professional, experienced in evaluating for concussion, says s/he is symptom-free and it’s OK to return to play. 2. Rest is key to helping an athlete recover from a concussion. Exercising or activities that involve a lot of concentration, such as studying, working on the computer, and playing video games, may cause concussion symptoms to reappear or get worse. After a concussion, returning to sports and school is a gradual process that should be carefully managed and monitored by a health care professional. 3. Remember: Concussions affect people differently. While most athletes with a concussion recover quickly and fully, some will have symptoms that last for days, or even weeks. A more serious concussion can last for months or longer. WHY SHOULD AN ATHLETE REPORT THEIR SYMPTOMS? If an athlete has a concussion, his/her brain needs time to heal. While an athlete’s brain is still healing, s/he is muchmore likely to have another concussion. Repeat concussions can increase the time it takes to recover. In rare cases,repeat concussions in young athletes can result in brain swelling or permanent damage to their brain. They can even be fatal. JOIN THE CONVERSATION www.facebook.com/CDCHeadsUp TO LEARN MORE GO TO >> WWW.CDC.GOV/CONCUSSION Player's Printed Name * Signature of Player * Clear Parent's Printed Name * Signature of Parent/Guardian * Clear Date * Parent / Guardian Consent and Player Medical Release Form Affiliate Name * West Genesee Downriver City Gender: * Boys Girls Street Address: * City * State * Zip Code: * Parent / Guardian Name (1): * Parent / Guardian (1) Home Phone * Parent / Guardian (1) Work Phone Parent / Guardian Name (2): Parent / Guardian (2) Home Phone Parent / Guardian (2) Work Phone In an emergency, when parents / guardians cannot be reached, please contact: Emergency Contact (1) Name: * Emergency Contact (1) Home Phone: * Emergency Contact (1) Work Phone: * Emergency Contact (2) Name: * Emergency Contact (2) Home Phone: * Emergency Contact (2) Work Phone: * Allergies: * Other Medical Conditions: * Player's Physician: * Physician Office Phone: * Medical and/or Hospital Insurance Company: * Insurance Phone Number: * Policy Holder: * Policy # * Group #: * PARENT/GUARDIAN CONSENT AND MEDICAL RELEASE Recognizing the possibility of injury or illness, and in consideration for US Youth Soccer and members of US Youth Soccer accepting my son/daughter as a player in the soccer programs and activities of US Youth Soccer and its members (the "Programs"), I consent to my son/daughter participating in the Programs. Further, I hereby release, discharge, and otherwise indemnify US Youth Soccer, its member organizations and sponsors, their employees, associated personnel, and volunteers, including the owner of fields and facilities utilized for the Programs, against any claim by or on behalf of my player son/daughter as a result of my son's/daughter’s participation in the Programs and/or being transported to or from the Programs. I hereby authorize the transportation of my son/daughter to or from the Programs. My player son/daughter has received a physical examination by a licensed medical doctor and has been found physically capable of participating in the sport of soccer. I have provided written notice, which is submitted in conjunction with this release and attached hereto, setting forth any specific issue, condition, or ailment, in addition to what is specified above, that my child has or that may impact my child's participation in the Programs. I give my consent to have an athletic trainer and/or licensed medical doctor or dentist provide my son/daughter with medical assistance and/or treatment and agree to be financially responsible for the reasonable cost of any such assistance and/or treatment. Your email address you want the completed form sent to: * Enter Email Confirm Your email address you want the completed form sent to: * Confirm Email After you hit the submit key, it may take up to 2 minutes for the form to be generated. After the form is submitted, you will be automatically sent to a confirmation page. Do not press "Submit" multiple times. Submit If you are human, leave this field blank.