You will be able to register up to 4 children with the on-line registration service. If you need to register more than 4, please join us at one of our in person registrations in August.
There is a fee table to help you calculate your total registration cost when you get to the payment page. You may pay by visa, mastercard. Please have this ready. If you exit the form you will have to start over. Please provide as much of the information asked for (yes, some is redundent - but necessary). If you have any questions please email us at email@example.com.
INFORMED CONSENT/INSURANCE NOTICE
FYSA RECOMMENDS THAT PLAYERS NOT REGISTER TO A TEAM WHOSE AGE GROUP EXCEEDS THE PLAYER’S NORMAL AGE. It is FYSA’s policy that all players compete at a level they are capable of both physically and developmentally. For a player to move up more than one normal age grouping will require approval from the affiliate’s director of coaching or agent of record, and the FYSA director of coaching.
INSURANCE NOTICE: All injuries must be reported within 90 days of the date of the injury.
INFORMED CONSENT: I, the parent/guardian of the registrant, agree that we will abide by the rules of Nature Coast Soccer Club, the state association (FYSA), and all its affiliated organizations. My/our child wishes to participate in soccer during the season of this registration. I/we realize risks are involved in my/our child’s participation. I/we understand that the risk to my/our child includes full range of injuries from minor to severe, and the result could be death, paralysis, or other serious, permanent disability. I/we accept this risk as a condition of my/our child’s participation.
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Recognizing the possibility of physical injury associated with soccer and in consideration for the USSF/US Youth Soccer and its affiliates accepting the registrant for its soccer programs and activities (the “Programs”), I hereby release, discharge and/or otherwise indemnify the USSF/US Youth Soccer, its affiliated organizations and sponsors, their employees and associated personnel, including the owner of fields and facilities utilized for the Programs against any claim by or on behalf of the registrant as a result of the registrant’s participation in the Programs and/or being transported to or from the same, which transportation I hereby authorize.
My son/daughter has received a physical examination by a physician and has been found physically capable of participating in the Programs. I hereby give my consent to have an athletic trainer and/or doctor of medicine or dentistry provide my son/daughter with medical assistance and/or treatment and agree to be responsible financially for the reasonable cost of each assistance and/or treatment.
Effective July 1, 2012, Florida Statute 943.0438 requires the parent or guardian and the youth who is participating in athletic competition or who is a candidate for an athletic team to sign and return an informed consent that explains the nature and risk of concussion and head injury (including the risk of continuing to play after a concussion or head injury) each year before participating in athletic competition or engaging in any practice, tryout, workout, or other physical activity associated with the youth’s candidacy for an athletic team.
What is a concussion? A concussion is an injury that changes how the cells in the brain normally work. A concussion is caused by a blow to the head or body that causes the brain to move rapidly inside the skull. Even a “ding”, “getting your bell rung”, or what seems to be a mild bump or blow to the head can be serious. Concussions can also result from a fall or from players colliding with each other or with obstacles, such as a goalpost, even if they do not directly hit their head.
To help recognize a concussion, you should watch for the following things among your athletes:
1. A forceful blow to the head or body that results in rapid movement or the head
2. Any change in the athlete’s behavior, thinking, or physical functioning
3. Signs or symptoms of concussion that may be reported by a coach or other observer:
a. Appears dazed or stunned
b. Is confused about assignment or position
c. Forgets sports plays
d. Is unsure or game, score or opponent
e. Moves clumsily
f. Answers questions slowly
g. Loses consciousness (even briefly)
h. Can’t recall events prior to hit or fall
4. Signs and symptoms that may be reported by the player:
a. Headache or pressure in the head
b. Nausea or vomiting
c. Balance problems or dizziness
d. Double or blurry vision
e. Sensitivity to light
f. Sensitivity to noise
g. Feeling sluggish, hazy, foggy, or groggy
h. Concentration or memory problems
j. Does not feel right
Both parents/guardians and players are advised to take the Center for Disease Control’s free online concussion training HERE.
Under Florida law, this player who has suspected concussion or head injury must be removed from play or practice. Before the player may return to practice or competition a written medical clearance to return stating that the youth athlete no longer exhibits signs, symptoms, or behaviors consistent with a concussion or other head injury must be received from an appropriate health care professional trained in the diagnosis, evaluation, and management of concussions. In Florida, an appropriate health-care professional (AHCP) is defined as either a licensed physician (MD, as per Chapter 458, Florida Statutes), a licensed osteopathic physician (DO, as per Chapter 459, Florida Statutes), a licensed physicians assistant under the supervision of a MD/DO (as per Chapters 458.347 and 459.022, Florida Statutes) or health care professional trained in the management on concussions.
Registration fee - $85.00 (includes $15 registration fee for Florida Youth Soccer Association, regular season activities, and uniform)
Additional Children from same family. - Each additional child will recieve a $10 discount on registration fee.
Volunteer Hold Back - $25 per family. All families participate in the hold back payment of this fee. The fee is returned at the end of each season if one or more family memeber completes 4 hours of volunteer service to the club. Service can include coaching, concession, field set up/ clean up, assistance with special activities and many more opportunities.)
Total fee table
For payment by cash or check please visit us at one of or in-person registration dates found at www.naturecoast.com .