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2020/21 Columbus Futsal Academy Evaluations

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  AGE GROUP ('20-'21) 
                    
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 Approvals

I, the parent/guardian of the above named Registrant, in consideration for accepting the Registrant for their Futsal programs and activities (collectively the “Programs”) hereby grants to US Youth Futsal and its member clubs and organizations, the right and permission, free from approval, review or cost, to photograph, record or otherwise capture the Registrants likeness in participating in the Programs for use in media, now or hereafter known, including, but not limited to pictures and video, to copyright the same in its own name, and which may be included in whole or in part for commercial or promotional use

12-12.

I, the parent/guardian of the above named Registrant, in consideration of accepting the Registrant for their Futsal programs and activities (collectively the “Programs”) and recognizing the risk of potentially significant physical injury occurring by participation in the Programs, including permanent disability or death, for myself and Registrant, do knowingly and freely assume all such risks, both known and unknown, and assume full responsibility for the Registrants participation in the Programs. Further, I, for myself and Registrant, and on behalf of our respective heirs, assigns, personal representatives and next of kin, do hereby release, indemnify and hold harmless United States Youth Futsal , its affiliated organizations and sponsors, and each of their employees, volunteers, agents, other participants, hosts, sponsors, advertisers, and the owners of the premises upon which the Programs are held (collectively, the "Releases"), with respect to any and all injury, disability, death, or loss or damage to person or property incident to Registrants participation in the Programs, and/or being transported to or from the same, which transportation I hereby authorize, and whether arising from the negligence of the Releases or otherwise, to the fullest extent permitted by law. I hereby warrant and represent that the Registrant has received a physical examination by a physician and has been found physically capable of participating in the Programs with no reservations or restrictions. I, for myself and Registrant, do hereby consent to have a doctor of medicine or dentistry, a licensed nurse or emergency technician provide Registrant with medical assistance and/or treatment and agree to be financially responsible for the cost of such assistance and/or treatment. 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
10/12

INFECTIOUS DISEASE WAIVER -PLAYERS In consideration of being permitted to participate in the Futsal event/activity including, but not limited to, practices, games, programs and related events and activities, the undersigned understands, acknowledges and agrees that: 1.Participation in such events or activities by my child and myself involves the possible exposure to and illness from infectious and/or communicable diseases including, but not limited to, COVID-19, MRSA, influenza, and other infectious or communicable diseases. While adherence to particular rules and requirements may reduce the risk of possible exposure, the risk of serious illness and death remains; and 2.On behalf of my child and myself, I knowingly and freely ASSUME ALL SUCH RISKS, both known and unknown, even if arising from the negligence of the Releasees or others, and assume full responsibility for my participation; and 3.On behalf of my child and myself, I agree to comply with all rules, regulations or conditions established by Team Galiffo Garcia and Columbus Futsal Club, Columbus Futsal Academy and the State of Ohio for participation in such events or activities. If, however, I observe any violation of the rules, regulation or conditions established by Team Galiffo Garcia and Columbus Futsal Club and Columbus Futsal Academy the State of Ohio during my presence or participation, I shall remove myself from participation and immediately bring such matter to the attention of the director or a staff member; and 4.On behalf of my child and myself, I, for myself and on behalf of my heirs, assigns, personal representatives and next of kin, HEREBY RELEASE AND HOLD HARMLESS Team Galiffo Garcia, its officers, officials, agents, employees, Members, Leagues and Associations, clubs, other participants, sponsoring agencies, sponsors, advertisers, and if applicable, owners and lessors of premises used to conduct the event or activityin which I participate (“RELEASEES”), from and against any and all claims of whatever type or kind including any illness, disability, death, or other loss or damage to person or property, whether arising from the negligence of Releasees or otherwise to the fullest extent permitted by law. Further, I expressly agree that this release is intended to be as broad and inclusive as permitted by the laws of the State of Ohio or any other state in which my/our child may participate in any event or activity described herein, and that if any portion of this release is determined to be invalid, it is agreed that the remaining provisions of this release shall continue in full force and effect. Finally, I further state that I have fully and carefully read the above release, understand the contents of the same and sign this release voluntarily and as my own free act and deed. I HAVE READ THIS RELEASE OF LIABILITY, HOLD HARMLESS AND ASSUMPTION OF RISK AGREEMENT, FULLY UNDERSTAND ITS TERMS, UNDERSTAND THAT I, ON BEHALF OF MY CHILD AND MYSELF, HAVE GIVEN UP SUBSTANTIAL RIGHTS BY SIGNING IT, AND SIGN FREELY AND VOLUNTARILY WITHOUT ANY INDUCEMENT.
CODE OF CONDUCT

Honor Code
All players, coaches, referees, spectators, club officials and administrators registered or associated with Team Galiffo Garcia, LLC, aka Columbus
Futsal Club, Columbus Futsal League and Columbus Futsal Academy (Columbus Futsal), shall report and cooperate in the investigation into any
possible violations of US Soccer, US Youth Futsal, Columbus Futsal League, Columbus Futsal or any other applicable rules or policies. Reports of
violations should be directed to the Columbus Futsal owners Malissa Galiffo and Dante Garcia. The failure to report, or cooperate in investigations
of a rule/policy violation is the equivalent to committing the violation. Violators are expected to voluntarily resign or face the possibility of
sanctions and/or expulsion from Columbus Futsal.

Prohibited Behavior - Policy Statement
1. Columbus Futsal is committed to promoting an environment that is free from: harassment and violence in any form; verbal or physical
intimidation; vandalism; drug, alcohol or tobacco use; gambling; and inappropriatelanguage.
2. These policies apply to all players, parents, coaches, referees, club officials and administrators registered or associated with Columbus
Futsal and spectators.
3. These policies shall be enforced at all Columbus Futsal sanctioned activities, including, but not limited to, league games, State Cup
games, invitational tournaments, district and state tournaments, and league competitions whether or not they are sanctioned. These
policies shall also apply to activities outside Ohio.
4. Columbus Futsal will not discriminate on the basis of disability. Columbus Futsal will provide persons with disabilities the opportunity to
participate in Columbus Futsal sponsored or sanctioned activities, provided such participation does not threaten the health or safety of
others.
5. Columbus Futsal reserves the right to exclude an individual's participation in a Columbus Futsal sponsored or sanctioned activity in order
to comply with applicable law.

Types of Prohibited Behavior
The following behaviors are prohibited. Any behavior that is not listed but violates the general spirit and intent of this rule is also prohibited and
subject to the same sanctions as described below, these behaviors are prohibited whether they are verbal, physical or electronic actions.
1. Assault - Assault is defined as either (1) an act done with intent to cause fear in another of immediate bodily harm or death; or (2) the
intentional infliction of or attempt to inflict bodily harm upon another; or (3) the threat to do bodily harm to another with the present ability
to carry out the threat.
2. Harassment - Harassment includes verbal, physical and/or electronic conduct that denigrates or demonstrates hostility or aversion to an
individual because of his or her race, color, creed, religion, sex, national origin, or any other protected class status defined by local, state,
or federal law, or that of his or her relatives, friends or associates, and that: (1) has the purpose or effect of creating an intimidating, hostile
or offensive environment; (2) has the purpose or effect of unreasonably interfering with an individual's participation in a Columbus Futsal
sponsored or sanctioned activity; or (3) otherwise adversely affects an individual's opportunity to participate in a Columbus Futsal
sponsored or sanctioned activity. Harassment may consist of epithets, slurs, negative stereotyping, threatening or intimidating acts, as well
as written or graphic material, including, but not limited to, jokes and/or pranks.
3. Racial Violence - Racial violence is a physical act of aggression or assault upon another because of, or in a manner reasonably
related to, race.
4. Religious Violence - Religious violence is a physical act of aggression or assault upon another because of, or in a manner reasonably
related to,religion.
5. Sexual Harassment - Sexual harassment is a form of sexual discrimination that includes unwelcome sexual advances, requests for sexual
favors, sexually motivated physical contact or other verbal or physical conduct or communication of a sexual nature when: (1) submission
to such conduct is made either explicitly or implicitly a term or condition of participation in a Columbus Futsal sponsored or sanctioned
activity; (2) submission to or rejection of such conduct by an individual is used as a fact or decision affecting the individual's participation
in a Columbus Futsal sponsored or sanctioned activity; or (3) such conduct has the purpose or effect of unreasonably interfering with an
individual's participation in a Columbus Futsal sponsored or sanctioned activity.
6. Sexual Violence - Sexual violence is a physical act of aggression that involves the touching of another's intimate parts, either above or
underneath the other person's clothes, or forcing another to touch one's intimate parts, either above or underneath one's clothes. Intimate
parts include the primary genital area, groin, inner thigh, buttocks, or breast of a human being. Sexual violence is a crime. Sexual violence
may include, but is not limited to, (1) touching, patting, grabbing or pinching another person's intimate parts, either same sex or opposite
sex; (2) coercing or forcing sexual touching on another; (3) coercing or forcing sexual intercourse on another; (4) threatening to force
sexual touching or intercourse on another.
7. Taunting - Taunting is defined as verbal or physical conduct intended or designed to embarrass, ridicule, or demeananother. This
includes, but is not limited to, statements pertainingto race, religion, gender, or national origin.
8. Showboating - Showboating is defined as an excessive display or celebration leading to a delay in continuation of play, such as after a
goal is scored.
9. Vandalism - Vandalism is the intentional or negligent destruction of property.
10. Drug, Alcohol and Tobacco Use - Drug use is the illegal possession or ingestion, consumption, inhalation, or other use of a controlled
substance. Alcohol use is the possession or ingestion of alcohol in any form. Tobacco use is the ingestion of tobacco in any form.
11. Gambling - Gambling is defined as wagering or betting on the outcome of a game or player.
12. Inappropriate language - Inappropriate language is defined as the intentional or incidental use of obscene, profane, lewd, or vulgar
speech. Inappropriate language includes, but is not limited to, cursing and swearing.
13. Providing False Information - Knowingly providing false information to Columbus Futsal or its officials is prohibited. This includes
falsifying birth date information; altering member passes, attempting to use altered player passes, and other presentation of false
identification, or any other provision of false information.
14. Harassment of Officials, Referees, Coaches or Players - Harassment includes repeated incidents of intrusive or unwanted act, words,
or gestures that have a substantial adverse effect on the safety, security or privacy of another. Harassment may consist of repeated phone
calls, e-mails, and /or personal confrontations by an individual, either acting alone or through others, or collectively by a group of
individuals acting together.
15. Bribe of Officials, Referees, Coaches or Players - Bribing includes persuading someone to act in one's favor, typically illegally or
dishonestly, by a gift of money or other inducement.

Policies – (all reference to before, during and after an event, refer to while at the playing venue.)
1. During a futsal season, a player, coach, referee, Columbus Futsal club official or administrator, or spectator, shall not engage in racial,
religious, or sexual harassment or violence.
2. Before, during, or after a Columbus Futsal sponsored or sanctioned activity, a player, coach, referee, Columbus Futsal club official or
administrator, or spectator, shall not engage in violent behavior.
3. Before, during, or after a Columbus Futsal sponsored or sanctioned activity, a player, coach, referee, Columbus Futsal club official or
administrator, or spectator, shall not engage in taunting orshowboating.
4. Before, during, or after a Columbus Futsal sponsored or sanctioned activity, a player, coach, referee, Columbus Futsal club official or
administrator, or spectator, shall not vandalize public or private property.
5. During a futsal season, regardless of quantity, a player shall not: (1) use a beverage containing alcohol; or (2) use or consume,
have in possession, buy, sell, or give away any other controlledsubstance.
6. An individual attending an a sponsored or sanctioned game shall not use or consume, buy, sell or give away: any beverage containing
alcohol; tobacco in any form; or any other controlled substance while present at the playing venue. This rule does not apply to
consumption/possession of properly prescribed medication, for the prescribed person.
7. Before, during or after a Columbus Futsal sponsored or sanctioned activity or game, individuals attending a Columbus Futsal
sponsored or sanctioned activity or game shall not wager or gamble on its outcome or on the performance of a player.
8. Before, during or after a Columbus Futsal sponsored or sanctioned activity or game, individuals attending a Columbus Futsal
sponsored or sanctioned activity or game shall not bribe an official, referee, coach or player.
9. Before, during or after a Columbus Futsal sponsored or sanctioned activity, a player, coach, referee, Columbus Futsal club official or
administrator, or spectator, shall not use inappropriate language.
Sanctions
1. Violations of these policies may result in the imposition of any of the following sanctions: verbal or written warning; game(s) suspension;
partial or full season suspension; suspension for a defined period of time, temporary or permanent banishment, including as a spectator.
2. Players and coaches are cautioned that the sanctions imposed for violation of these policies are in addition to any discipline which may be
imposed by the referee during a game.
3. Violations of these policies shall be reported to the appropriate Columbus Futsal Director, as well as the Columbus Futsal owners for
assignment to the appropriate individual for investigation and disposition. Investigation will be done by an outside party whenever
possible.
4. If you are sanctioned for violating any of the policies and miss games or practices you are NOT entitled to any refund of any monies paid
for registration on the team. All monies paid are forfeited by theviolator.
5. If you are a Columbus Futsal employee or independent contractor, breach of this Code is a material breach of your agreement with
Columbus Futsal and Columbus Futsal may immediately terminate it.

I have read, understand and agree to comply with the Columbus Futsal CODE OF CONDUCT POLICY.
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 Refund Policy

There are no costs associated with CFA player evaluations.

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