Individual Player Registration

CONCUSSION INFORMED CONSENT

Pursuant to Florida Statute 943.0438, this form must be signed by all youth participants and parent/legal guardians 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. Concussion Information A concussion is a brain injury and all brain injuries are serious. They are caused by a bump, blow, or jolt to the head, or by a blow to another part of the body with the force transmitted to the head. Concussions can range from mild to severe and can disrupt the way the brain normally works. Even though most concussions are mild, all concussions are potentially serious and may result in complications including prolonged brain damage and death if not recognized and managed properly. In other words, even a "ding" or a “bump” on the head can be serious. You cannot see a concussion and most sports concussions occur without loss of consciousness. Signs and symptoms of concussion may show up right after the injury or can take hours or days to fully appear. If your child reports any symptoms of concussion, or if you notice the symptoms or signs of concussion yourself, seek medical attention right away. Signs and Symptoms Observed by Parents or Coaches • Appears dazed or stunned. • Forgets an instruction, is confused about an assignment or position, or is unsure of the 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 or after a hit or fall. Symptoms Reported by Youth Participants • Headache or “pressure” in head. • Nausea or vomiting • Balance problems or dizziness, or double or blurry vision. • Bothered by light or noise. • Feeling sluggish, hazy, foggy, or groggy. • Confusion, or concentration or memory problems. • Just not “feeling right,” or “feeling down.” What can happen if my child keeps on playing with a concussion or returns too soon? Youth participants with the signs and symptoms of concussion must be removed from play immediately. Continuing to play with the signs and symptoms of a concussion leaves the youth participant especially vulnerable to greater injury. There is an increased risk of significant damage from a concussion for a period of time after that concussion occurs, particularly if the youth participant suffers another concussion before completely recovering from the first one (second impact syndrome). This can lead to prolonged recovery, or even to severe brain swelling with devastating and even fatal consequences. It is well known that adolescent or teenage athletes will often under report symptoms of injuries, and concussions are no different. As a result, education of administrators, coaches, parents and players are the key for youth participant’s safety.
If you think your child has suffered a concussion No athlete may return to activity after an apparent head injury or concussion, regardless of how mild it seems or how quickly symptoms clear, without written medical clearance from a Medical Doctor (MD) or Doctor of Osteopathic Medicine (DO) who is familiar with the Close observation of the youth participant should continue for several hours. Parent/Legal guardian should also inform their child's coach if they suspect their child may have a concussion. Remember it is better to miss one game than miss the whole season. When in doubt, the youth participant sits out! Return to Practice and Competition: Clearwater City FC follows Florida Statute 943.0438, provides that if an athlete suffers, or is suspected of having suffered, a concussion or head injury during a competition or practice, the youth participant must be immediately removed from the competition or practice and cannot return to practice or competition until a Health Care Professional has evaluated the youth participant and provided a written authorization to return to practice and competition. CLEARWATER CITY FC recommends that a youth participant not return to practice or competition the same day the athlete suffers or is suspected of suffering a concussion. CLEARWATER CITY FC also recommends that a youth participant's return to practice and competition should follow a graduated protocol under the supervision of the health care provider (MD or DO). For more information from the CDC on concussions you can go to: https://www.cdc.gov/headsup/youthsports/index.html. By signing this agreement, the youth player acknowledges the information on this form have been read and understood.

CLEARWATER CITY FC COMMUNICABLE DISEASE RELEASE OF LIABILITY AND ASSUMPTION OF RISK AGREEMENT

In consideration of being allowed to participate in any way in any CLEARWATER CITY FC related events and activities I, the undersigned participant, parent, or legal guardian, acknowledge, appreciate, and agree that: By participating in CLEARWATER CITY FC related events and activities, there are certain risks to me arising from or related to possible exposure to communicable diseases including, but not limited to, the virus “severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)”, which is responsible for the Coronavirus Disease (also known as COVID-19) and/or any mutation or variation thereof (collectively referred to as “Communicable Diseases”). I am fully aware of the hazards associated with such Communicable Diseases and knowingly and voluntarily assume full responsibility for any and all risk of personal injury or other loss that I may sustain in connection with such Communicable Diseases. I, for myself or for my minor child(ren) or ward(s), and on behalf of my/our heirs, assigns, beneficiaries, executors, administrators, personal representatives, and next of kin, HEREBY EXPRESSLY RELEASE, HOLD HARMLESS, AND FOREVER DISCHARGE CLEARWATER CITY FC, INC. and its officers, officials, agents, representatives, employees, other participants, sponsors, advertisers, and, if applicable, owners and lessors of premises upon which CLEARWATER CITY FC related events and activities take place (the “Released Parties”), from any and all claims, demands, suits, causes of action, losses, and liability of any kind whatsoever, whether in law or equity, arising out of or related to any ILLNESS, INJURY, DISABILITY, DEATH, OR OTHER DAMAGES incurred due to or in connection with any Communicable Diseases, WHETHER ARISING FROM THE NEGLIGENCE OF THE RELEASED PARTIES OR OTHERWISE, to the fullest extent permitted by law. I agree that this Agreement is intended to be as broad and inclusive as is permitted by the laws of the State of Florida, and if any portion hereof is held invalid, it is agreed that the remainder shall continue in full legal force and effect. 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.
FOR PARENTS/GUARDIANS OF PARTICIPANT OF MINOR AGE (UNDER AGE 18 AT TIME OF REGISTRATION) I certify that I am the legal parent/guardian with responsibility for this participant, and that I have read the foregoing Agreement and do consent and agree to his/her release of all the Released Parties as provided above. I further agree that, for myself, my heirs, assigns, beneficiaries, executors, administrators, personal representatives, and next of kin, I expressly release and agree to indemnify and hold harmless the Released Parties from any and all liability incident to the above Participant’s involvement or participation in CLEARWATER CITY FC related events or activities as provided herein, EVEN IF ARISING FROM THE NEGLIGENCE OF THE RELEASEES, to the fullest extent permitted by law.

Clearwater City FC – Code of Conduct

At Clearwater City FC, we are committed to fostering a positive, respectful, and safe environment for all players, coaches, parents, and supporters. This Code of Conduct outlines the expectations for everyone involved with the club to ensure that our community is built on mutual respect, sportsmanship, and integrity.

Players:   

1.     Respect: Treat your teammates, coaches, opponents, referees, and all participants with respect at all times, on and off the field.

2.     Sportsmanship: Play fair, demonstrate good sportsmanship, and never engage in violent or disrespectful behavior.

3.     Effort: Always give your best effort in training, matches, and competitions. Stay committed to improving and learning.

4.     Communication: Listen to your coaches and teammates, and communicate openly and respectfully with everyone.

5.     Teamwork: Prioritize the success of the team over individual accomplishments, and work collaboratively to achieve common goals.

6.     Responsibility    : Arrive on time for training, matches, and events, and take care of your personal equipment and club facilities.

7.     Attitude: Maintain a positive attitude, even in the face of challenges or setbacks. Stay focused and be a role model for others.

             Parents and Supporters:   

1.     Support: Encourage and support all players, coaches, and officials in a positive and respectful manner.

2.     Respect the Game: Avoid coaching from the sidelines or engaging in negative comments about the referees, opposing team, or players.

3.     Role Models: Demonstrate good sportsmanship by showing respect for all players, coaches, officials, and spectators.

4.     Patience: Remember that development takes time, and focus on the progress of your child, not just the results of the game.

5.     Encouragement: Celebrate effort and improvement, regardless of the game’s outcome. Create a positive environment for all children to grow and enjoy the game.

6.     Conduct: Refrain from using foul language, aggressive behavior, or negative outbursts during practices, games, or events. Any disruptive behavior will not be tolerated.

Disciplinary Action: Failure to adhere to the Clearwater City FC Code of Conduct may result in disciplinary action, including but not limited to:

- Verbal or written warnings

- Suspension from practices, games, or club events

- Permanent removal from the club

Clearwater City FC expects all members to uphold the values of respect, integrity, and sportsmanship. By participating in our programs, you agree to abide by this Code of Conduct and contribute to a positive, inclusive, and supportive soccer community.

Photo and Video Release Form

By signing this form, I hereby grant Clearwater City FC, its representatives, and employees the right to take photographs, video recordings, or other digital media (collectively referred to as “media”) of the participant named above, in connection with their participation in Clearwater City FC activities.

I further authorize Clearwater City FC, its affiliates, and sponsors to use, reproduce, and/or publish any media, in whole or in part, for any lawful purpose, including but not limited to promotional materials, social media, advertising, website content, and other club-related publications, without further compensation or notification.

I understand that:

1. All media will become the property of Clearwater City FC and may be used without time limitations.

2. Media may be edited, altered, copied, exhibited, or distributed at Clearwater City FC’s discretion.

3. I waive the right to inspect or approve the finished media, its usage, or any printed or electronic matter that may be used in conjunction with it.

4. I release and hold harmless Clearwater City FC, its representatives, employees, and any third parties involved from any claims, demands, or liability that may arise in relation to the use of the media.

CLEARWATER CITY FC WAIVER AND RELEASE OF LIABILITY

I, the undersigned participant (or parent/guardian if participant is under 18), acknowledge and fully understand that participation in soccer/futsal involves risks, including but not limited to falls, contact with other players, and potential injuries such as sprains, fractures, concussions, or more serious injuries. I voluntarily choose to participate in Clearwater City FC Futsal program, which includes scrimmages with other entities, and assume all risks associated with such activities.

I hereby release, discharge, and hold harmless Oak Grove Middle School, Pinellas County School Board, and Clearwater City FC, its directors, officers, coaches, volunteers, and any affiliated organizations from any and all claims, liabilities, damages, or losses arising from my (or my child’s) participation in club activities, including practices, games, travel, and related events.