Illinois Youth Soccer Association Girls Emergency Medical Release & Liability Waiver
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1 Illinois Youth Soccer Association Girls Emergency Medical Release & Liability Waiver Girl=s Name Birthdate Street Address City Zip EMERGENCY INFORMATION Father's Name Home Phone ( ) Bus Phone ( ) Mother's Name Home Phone ( ) Bus Phone ( ) In an emergency when parent/guardian cannot be reached, please contact the following: Name Home Phone ( ) Bus Phone ( ) Name Home Phone ( ) Bus Phone ( ) Allergies Other Medical Conditions Physician Home Phone ( ) Bus Phone ( ) Medical/Hospital Insurance Company Phone ( ) Policy Holder's Name Policy Number THIS AUTHORIZATION FOR EMERGENCY MEDICAL TREATMENT MUST BE COMPLETED BEFORE A PLAYER/YOUTH REFEREE BEGINS PARTICIPATION. TREATMENT FOR INJURY WILL BE BASED ON INFORMATION PROVIDED HEREIN. I the undersigned (if applicant/participant is 18 years of age or older) or parent/guardian of the above listed minor applicant/participant acknowledge and fully understand that each applicant/participant will be engaging in activities that involve risk of serious injury, including permanent disability or death, and severe social and economic losses which might result not only from their own actions, inactions or negligence, but action, inaction or negligence of others, the rules of play, or the condition of the premises or of any equipment used and further, that there may be other unknown risks not reasonably foreseeable at this time, assume all the foregoing risk and accept personal responsibility for the damages following such injury, permanent disability or death, hereby release, discharge, covenants to indemnify and not to sue Illinois Youth Soccer Association, its affiliated organizations and sponsors, their coaches, managers, employees and associated personnel, officers, directors, agents, including the owners and leasers of premises used to conduct the event, all of which are hereinafter referred to as 'releasees', from any and all liability to each of the undersigned, his/her heirs or next of kin for any and all against any claim by or on behalf of the applicant as a result of the applicant's's participation in the Programs and/or being transported to or from the same, which participation, after careful consideration I hereby authorize, and which transportation I hereby authorize. The applicant/participant 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, coach and/or doctor of medicine or dentistry or associated personnel to provide the applicant/participant with medical assistance and/or treatment and agree to be financially responsible for the cost of such assistance and/or treatment. I, also agree to save and hold harmless and indemnify each and all parties herein referred to above as releasee from all liability, loss, cost, claim or damage whatsoever, including death or damage to property, which may be imposed upon said releasee because of any defect in or lack of such capacity to so act or caused or alleged to be caused in whole or in part by the negligence of the releasee. I have read the above waiver/release and understand that (I)we have given up substantial rights by signing this release and sign below voluntarily. med. rel revised 1/8/02 Parent/Guardian Signature Date NOTE: ATTACH COPY OF YOUR INSURANCE CARD, FRONT AND BACK, TO EXPEDITE MEDICAL TREATMENT.
2 Illinois Women s Soccer League PO Box 68849, Schaumburg, IL PLAYER REGISTRATION FORM For The Playing Year CLUB NAME: Challengers Soccer Club Tryout Label # TEAM NAME: TEAM AGE: PLAYER S FIRST NAME LAST NAME: PLAYER S ADDRESS CITY: STATE: ZIP: PLAYER S PHONE(s) ADDRESS PLAYER S BIRTHDATE / / FATHER S NAME PHONE(s) ADDRESS MOTHER S NAME PHONE(s) ADDRESS PROOF OF AGE: PREVIOUS SEASON IWSL PASS ID # Or PROOF OF AGE PROVIDED: GOVERNMENT ISSUED BIRTH CERT or PASSPORT (Circle one) By signing this document I have indicated that I (or my child) has not registered with any other IYSA registered team for the above indicated playing year and is committed to play for only this team. I am aware that IWSL league rules only permit transfers if desired to other clubs during or after the month of January with an applicable release obtained and submitted per league rules. PLAYER S SIGNATURE DATE PARENT S SIGNATURE DATE CLUB/COACH SIGNATURE DATE (This form is to be kept on file by the club for the entire playing year indicated)
3 Challengers Soccer Club Waiver Save yourself some time. Please print and complete this sheet and bring it to your tryout along with a printed copy of the electronic registration form. (Extra forms will likely be available at tryout). Player s Name: Gender: M F Date of Birth: / / Parent s Name(s): Home: Cell: Please circle 2010/11 age: Born 2009/ /11 8/1/91 & Later U18 U19 8/1/92 & Later U17 U18 8/1/93 & Later U16 U17 8/1/94 & Later U15 U16 8/1/95 & Later U14 U15 8/1/96 & Later U13 U14 8/1/97 & Later U12 U13 8/1/98 & Later U11 U12 8/1/99 & Later U10 U11 8/1/00 & Later U9 U10 8/1/01 & Later U8 U9 8/1/02 & Later U7 U8 Office Use: Label # Birth Cert: Medical Release: Insurance Card: Head Shot: League Comit: Deposit Check # Date: Amount: $ Follow up Notes: WAIVER & RELEASE OF ALL CLAIMS Please read this form carefully and be aware in registering your minor child/ward for participation in club event(s), such as, but not limited to, clinics, tryouts, practices, games, and tournaments, you will be waiving and releasing all claims for injuries you or your minor child/ward might sustain arising out of the event(s). I recognize and acknowledge that there are certain risks of physical injury to participants in the event(s) and I agree to assume the full risk of any injuries, including death, damages, or loss, regardless of severity, which I or my minor child/ward may sustain as a result of participating in any and all activities connected with or associated with such event(s). I agree to waive and relinquish all claims I or my minor child/ward may have against the Challengers Soccer Club and its officers, directors, agents, servants, volunteers, and employees as a result of participating in the event(s). I do hereby fully release and discharge the Challenger Soccer Club and its officers, directors, agents, servants, volunteers and employees from any and all claims from injuries, including death, damage, or loss, which I or my minor child/ward may have or which may accrue to me or my minor child/ward and arising out of, connected with, or in any way associated with the activities of the event(s). I further agree to indemnify and hold harmless and defend the Challengers Soccer Club and its officers, directors, agents, servants, volunteers, and employees from any and all claims resulting from injuries, including death, damages, and losses, sustained by me or my minor child/ward, arising out of, connected with, or in any way associated with the activities of the event(s). I have read and fully understand the waiver and release of all claims. Signature of Parent or adult Guardian Date
4 Girls Tues., June 1st or make up Fri., June 4th U8 & U9 5:00-6:30pm U10 & U11 5:30-7:00pm U12 & U13 6:00-7:30pm U14 6:30-8:00pm 2010 Fall Tryouts Boys Wed., June 2nd or make up Fri., June 4th U8 & U9 5:00-6:30pm U10 & U11 5:30-7:00pm U12 & U13 6:00-7:30pm U14 6:30-8:00pm High School Girls U15 Tryouts Sat., May 22nd, 11:00am High School Boys do not need to register until winter /Yr.
5 NAPERVILLE CHALLENGER SOCCER Club Frequently Asked Questions How old is the Naperville Challengers organization? Why was it formed? The Naperville Challengers was started in fall 2003 by experienced parent coaches who had specific goals on how to better balance the time and expense associated with travel soccer. Our goals were to provide our children with a more competitive soccer environment, teach the kids fundamentals, encourage practicing on their own, bringing the feeling of neighborhood back to the game, allow parents to have some influence on the team arrangements, retain players from season to season and save on wasted costs and time. The concept became very popular. By doubling the number of teams each year the club expanded rapidly to 28 teams. Who runs the Naperville Challengers? The Naperville Challengers Soccer Club is an association of autonomous teams that cooperate and support each other. Decisions for each team is are made by team leaders in collaboration with the other parents. Volunteer decision makers enable kids and soccer to be our focus rather than revenue. Professional Trainers are frequently hired at the team level. The club has is pursuing a 501c3 incorporation and non-for profit status. Corporate status allows us to improve services by hiring a small part time staff to oversee club level duties. The initial staff is the same volunteers who were filling these club level roles as the club grew in numbers and doubled each year. Who coaches the Naperville Challengers? In most cases, professional trainers are hired but supervised by a parent managers and coaching volunteers from your team. We have been lucky in that most of our coaches are highly qualified and experienced soccer-playing volunteers with a child on the team. Coaches and managers are parents too, with the same concerns as you. Their soccer experience includes competitive high school, college, and European teams and many years of coaching experience. Many of the head coaches are still actively playing soccer. Background checks are performed by our leagues on all coaches, trainers, and others with direct child contact. Naperville Challengers head coaches attend NISL/IWSL training and meetings, hold required certifications, and adhere to Disclosure Statements. Our coaching philosophy is to have fun playing competitive soccer while developing core technical soccer skills. Under parent and coach guidance, each team may also choose to use external professionally certified trainers. The Naperville Challengers wholeheartedly supports and applies the "Youth Position," "Positive Coaching," and "Learning vs. Winning" position papers and concepts put forth by the NISL, IWSL, IYSA, and USSF. How many games are played per season? How often are practices? A soccer year consists of a Fall Season and a Spring Season. Each season has 8-10 games. Team practices are 2-3 times per week at a local field. In addition the club offers a weekly club wide foot skills clinic lead by expert professional trainers. Games are usually played on Sundays against teams from the western Chicago suburbs. For the boys NISL hosts an annual seeding tournament in August to determine the most effective grouping of teams by skills. Teams generally also play 1 to 2 tournaments per season. Participating in indoor leagues over the winter is available but optional.. What costs are involved? Naperville Challengers fees are significantly lower than soccer clubs managed for profit or by paid staff who often charge $1,500-3,000 a full year. Our club s overhead is only around $100 per player per year. Our accounting books are open for anyone to see. Player fees for our teams range from $ per year. The fees cover direct costs of seeding and regular tournaments, field rental, trainer costs and league fees. If your team decides to participate in an indoor league, hold indoor practices, employ a professional trainer, or choose other options that include fees, the respective cost increase is shared fairly by the team parents but remains very low. Players keep their uniform until they grow out of it. Often uniforms last 3+ years. New players who budget about $130 for a uniform should have extra money. Uniforms are not a club fundraiser. You pay direct costs to your vendor. How many players are on a team? What type of playing time do they get? Age determines the number of players on the field for a game and maximum number of roster positions. The Naperville Challengers maintain low roster numbers to ensure maximum playing times. Is the Naperville Challengers part of state or national soccer organizations? The boy s teams play in the Northern Illinois Soccer League (NISL.info). The girl s teams play in the Illinois Women Soccer League (IWSL.org). The girls league is part of Illinois Youth Soccer Association (IYSA.org), and the boys are part of USSoccer.com Both are part of U.S. Soccer Federation (USSF), the governing body of all soccer in the United States. How can I get more information? To locate team contact information, visit or Visit our website at
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