Individual Player Registration

2024-25 Clearwater City FC

Option:  

Required  Price: $185.00
Description: $185 per player
 = Required Field

 

 
 
 
 
  Select Month/Day/Year
 
 
 Emergency Contact 
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 Approvals

I understand that in addition to the league fees, each player must register with United States Youth Futsal (USYF).  The $13.50 per player fee and player releases are completed and paid online by the player/parent/guardian (P/P/G).  Players will not be eligible to participate unless payment is received and released authorized. 

The USYF player registration link will be included in the registration confirmation email.

Outdoor player registrations issued from US Club, AYSO, USYSA, State Associations. etc. are not valid for registration with USYF.

 Once the event begins, there is no refund of the fee.


6/2020

CRITICAL NOTICE- Double-check the name of the player and the date of birth (DOB) above to confirm they are input correctly or the USYF registration will not be valid.  Also, if the player has already registered and paid the USYF player registration fee in the current year (8/1/2024 - 7/31/2025), to avoid having to pay again, you must enter the player information exactly as it was input the first time the player was input and paid for the current year.  Changing the player name or DOB from the previous registration will cause the system to recognize the player as a new player and will charge the fee again

 

6/2024


 


 

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.

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.


 CONTACT INFORMATION

GUARDIAN #1

 
 STATE 
 ZIPCODE 
 1 of the 3 phone numbers below must be filled in
 HOME 
 WORK 
 CELL 
 PREFERENCE 
GUARDIAN #2 (optional)

 
 STATE 
 ZIPCODE 
 1 of the 3 phone numbers below must be filled in
 HOME 
 WORK 
 CELL 
 PREFERENCE 

 Refund Policy

Thank you for registering for the (event)  You may cancel your registration before the registration deadline and receive a refund of your fees minus a $___ administrative fee.  After the registration deadline, no refunds will be given.

 Contact Info