North County Youth Association/ United Student Athletes Players Registration & Consent Form

North County Youth Association/ United Student Athletes Players Registration and Consent Form

2023 Season
Dear Parent / Guardian & Player. Welcome to NCYA/USA. For some, this will be your first experience of our organization, and we warmly welcome you.

Please ensure you complete and read all sections, anything added to this form will be held in confidence. The organization and our coaches need to know these details in order to meet the specific needs of your child.

Medical Information
Details of any known conditions, allergies etc (asthma, diabetes, epilepsy, foods):
Any medication being taken:*

YesNo
Any other special need, requirements/ directions that would be helpful for coaches to know about
Additional Emergency Contact Details (if the parent / Guardian cannot be reached)

First NameLast Name
Phone Number

Area CodePhone Number
I will inform the Organization /Coaches of any important changes to my child’s health, medication or needs and also of any changes to our address or phone numbers given above. In the event of illness, having parental responsibility for the above named child, I give permission for medical treatment to be administered where considered necessary by a nominated first aider, or by suitably qualified medical practitioners. If I cannot be contacted and my child should require emergency hospital treatment, I authorise a qualified medical practitioner to provide emergency treatment or medication.*

YesNo

Players Code of Conduct
I have read, understood, and hereby agree to abide by the above players code of conduct. I will also ensure my child will read and abide by the code.*

YesNo

Parents Code of Conduct
I have read, understood, and hereby agree to abide by the above Parents code of conduct.*

YesNo

Club Policy
Payment of Player Fines
Please pay particular attention to this point, so as to save any confusion at a later date. Parents/Guardians will be responsible for payment to the club of any fines or administration costs incurred by their son/daughter whilst playing youth football for NCYA/USA. These will normally be through a sending off or caution.

Transport
I acknowledge that any arrangement to transport my child to or from organization games or activities is my responsibility. Determining the insurance or roadworthiness of vehicles or drivers is not the responsibility of North County Youth Association/ United Student Athletes or its officials.

Photography
I agree to photographs/videos of my son/daughter being taken by NCYA/USA for football purposes.

Car Park
Please respect Disabled parking bays. Please park sensibly in bays as marked. Please respect our patrons and also near neighbour’s, the residents of North County, by driving carefully and at a sensible speed when entering and leaving the car park.

Kit & Eqiptment
All Kit and equiptment provided by NCYA/USA remain the property of NCYA/USA and must be returned to the football organization immediately upon request or as and when a player leaves the organization.
I have read, understood, and hereby agree to abide by the above Club policy.*

YesNo

Sign & Submit
Player Registration is not complete until this form has been Signned and Submitted. A Player Registration Fee of $200 will also need to be collected.

I hearby confirm all information provided in this Player Registration & Consent form to be accurate to the best of my knowledge
Name

First NameLast Name
Signature

Clear

My Products*

USDFootball Registration

North County Youth Association/ United Student Athletes Players Registration and Consent Form