Financial Agreement Jaguar FC Teams Player Name Date of Birth - - ANNUAL ONE-TIME NON-REFUNDABLE CLUB Fee: $50 due at registration LEAGUE/TOURNAMENT/UNIFORM fees will be invoiced separately August 1 & March 1 Make all checks payable to Jaguar FC (Futbol Club) Overdue Accounts/Player Passes. Any player with a past due account of more than 30 days will no longer have access to his/her player pass. Until such time that the account is current, the player will be ineligible to participate in tournaments, team games, scrimmages, or practices. If a family has more than one child playing, this only impacts the player with the overdue account. No player will be released from the Club with a past due account. Late payments made after 15 days are automatically charged a late fee of $25.. By signing below, I hereby agree to pay the payment schedule proposed by the Jaguar Futbol Club (Jaguar FC). I understand the financial agreement as stated in the policies of the Club, and if my child leaves the club during the seasonal year, I will still pay all fees required by the club including but not limited to any Club, League, Tournament or Uniform fees outstanding. Print: Signed: Date:
Jaguar FC Player and Parent Agreement I understand my responsibilities as a player in the Jaguar Futbol Club program. I realize that soccer is a year round sport that I am expected to play in the fall and spring outdoor season. As a player, I will: 1. Honor all commitments required by the Jaguar Futbol Club. 2. Remain with the Jaguar Futbol Club and not transfer to another club during this seasonal year unless extenuating circumstances exist (ex: relocation, irreconcilable differences with organization) which must be documented. 3. Notify the Director of Coaching if a member of another club coaching staff or a parent approaches me for purpose of recruitment. 4. Not attend any other coaching training session or play for any other soccer organization without written permission from the Director of Coaching, respective of gender. Middle School, High School soccer, and ODP are accepted. 5. Attend all Jaguar Futbol Club training sessions and games as required. I understand that the coaches will decide who plays and that playing time is dependent on a number of factors. I realize that my soccer ability, practice attendance, and overall attitude are important factors that will affect my playing time. 6. Wear Jaguar Futbol Club gear to all games and training sessions. 7. Refrain from using foul language, alcohol, drugs, or anything in that sense that degrades my condition as an athlete. 8. Treat all teammates, opponents, officials, and coaches with courtesy, respect, and above all, good sportsmanship. 9. Represent the Jaguar Futbol Club with values and principles of the highest standard, both on and off the field. 10. Help volunteer for club events and hosted tournaments. 11. Not post any material on social media sites that may be offensive, harassing, discriminatory, bullying, or otherwise inappropriate. I, as the parent/legal guardian of the above player, realize my responsibilities as part of the JAGUAR FUTBOL CLUB program. As a parent, I will support JAGUAR FUTBOL CLUB programs. Questions shall be directed to individual coaches first and then to the Director of Coaching. Negative behavior or interference toward a referee, coach, player, or parent of any kind will not be tolerated. (Parent or Legal Guardian Signature) (Player s Signature) (PRINT Parent s Name) (PRINT Player s Signature)
Missouri Youth Soccer Association MEMBERSHIP FORM You must complete a separate form per team participating with TEAM NAME AGE/DIV Level of Play: Competitive Secondary Recreational If this is Secondary team dual roster for must be submitted with this paperwork and list name of the primary team Enter data for player/coach/administrator below. Name must be filled in as it appears on the player s state birth certificate. ID # First Name Middle Initial Last Name Address City State Zip Phone ( ) Birth date Month Date Year Email address ID# for players is the number on their state birth certificate. All players must submit a copy of their state birth certificate. ID# for coaches is their coaches license number. All coaches will be required to submit the copy of their coaches license and a copy of the confirmation page of the kidsafe disclosure statement. All team managers must submit a copy of the confirmation page of the kidsafe disclosure statement. This form must be done online at mysa.org. Father's Name Cell Phone Work Phone Mother's Name Cell Phone Work Phone List any medical problem or prohibition player has Emergency Contact Person (other than parents) Name Relationship Phone (H) Phone (W) PARENT SUPPORT Head Coach Assistant Coach School Attending Grade Team Parent Have you ever lived in a foreign country? If yes, when did you enter/re-enter the United States? (Any player U14 and older that answers yes or has a foreign birth certificate, must fill out the US Soccer International Clearance Request Waiver and submit to US Soccer before player can be rostered to team.) LIABILITY RELEASE MUST be signed by parent or legal guardian of player. Coaches must sign when completing form on self. I, the parent or legal guardian of the above registered player, a minor, agree that I and the player will abide by the rules and regulations of the USYSA, its affiliated organizations, and sponsors ("USYSA Parties"). In consideration of the player's participation in the soccer Programs and activities of the USYSA Parties (the Programs), I, for myself and the player and our respective heirs, administrators and successors, intending to be legally bound, hereby release and indemnify the USYSA Parties, the owners and operators of the facilities used for the Programs, and their respective directors, officers, employees, agents and representatives from and against all claims, liabilities, damages or causes of action arising out of or in connection with the player's participation in the Programs including, without limitation, player's transportation to/from any program, which transportation is hereby authorized. I future grant the USYSA Parties the right to use the Player's name, picture and/or likeness in printed, broadcast and other material concerning the Programs provided such use is related to the player's status as a participant in the Program. SIGNATURE DATE
PARENT/GUARDIAN CONSENT AND PLAYER MEDICAL RELEASE FORM Player s Name: Date of Birth: Gender: Address: City: State: Zip: EMERGENCY INFORMATION Father s Name: Home Phone: Work Phone: Mother s Name: Home Phone: Work Phone: In an emergency, when parents cannot be reached, please contact: Name: Home Phone: Work Phone: Name: Home Phone: Work Phone: Allergies: Other Medical Conditions: Player s Physician: Home Phone: Work Phone: Medical and/or Hospital Insurance Company: Phone: Policy Holder: Policy #: Group #: PLEASE COPY BOTH SIDES OF YOUR HEALTH INSURANCE CARD AND ATTACH TO THIS FORM PARENT/GUARDIAN CONSENT AND MEDICAL RELEASE Recognizing the possibility of injury or illness, and in consideration for US Youth Soccer and members of US Youth Soccer accepting my son/daughter as a player in the soccer programs and activities of US Youth Soccer and its members (the "Programs"), I consent to my son/daughter participating in the Programs. Further, I hereby release, discharge, and otherwise indemnify US Youth Soccer, its member organizations and sponsors, their employees, associated personnel, and volunteers, including the owner of fields and facilities utilized for the Programs, against any claim by or on behalf of my player son/daughter as a result of my son's/daughter s participation in the Programs and/or being transported to or from the Programs. I hereby authorize the transportation of my son/daughter to or from the Programs. My player son/daughter has received a physical examination by a licensed medical doctor and has been found physically capable of participating in the sport of soccer. I have provided written notice, which is submitted in conjunction with this release and attached hereto, setting forth any specific issue, condition, or ailment, in addition to what is specified above, that my child has or that may impact my child's participation in the Programs. I give my consent to have an athletic trainer and/or licensed medical doctor or dentist provide my son/daughter with medical assistance and/or treatment and agree to be financially responsible for the reasonable cost of any such assistance and/or treatment. Signature of Parent/Guardian Date
Kingcat.origin@gmail.com www.facebook.com/thejaguaracademy ACKNOWLEDGEMENT, RELEASE AND WAIVER OF LIABILITY Whereas, Jaguar Academy, Inc. ( Jaguar Academy ) and Jaguar FC is a nonprofit organization that is involved with instruction and training for youth soccer and other sports. Whereas, youth soccer involves running, stopping and other physical exertion and contact between players. The undersigned parent of the youth participating in Jaguar Academy instruction and training understand that there is a risk of injury and accept this risk by signing this release and waiver and allowing their youth to participate in soccer instruction, training, drills and practice. Whereas, I the undersigned, have been informed that I can remove my child from instruction, training, drills and prac-tice at any time. Whereas, I the undersigned, acknowledge that I am the parent or legal guardian of the below-named youth and that I am giving my permission for my child to participate in all instruction, training, drills and practice, without limitation. Whereas, I the undersigned, desire to release and waive potential liability that Jaguar Academy, its employees, agents, or other participants may incur while providing instruction, training, drills, practice for the youth listed below. I under-stand that this Release and Waiver is effective for all future instruction, training, drills and practice by Jaguar Academy from the date of this Release and Waiver. Now, therefore, I hereby waive, release and discharge Jaguar Academy and Jaguar FC for any and all claims for damages for death, personal injury, and/or property damage which I, or my heirs, may have or which may subsequently accrue to me or my heirs, as a result of, or arising from, my child participating in all instruction, training, drills and practice through Jaguar Academy and Jaguar FC. This Acknowledgement, Release and Waiver is intended to, and shall operate to, discharge in advance Jaguar Academy and Jaguar FC and its agents, employees, and contractors from and against any and all liability arising out of or connected in any way with my child's participation in all instruction, training, drills and practice. I give Jaguar Academy and Jaguar FC the right to take and create photographs, videos and other still and/or moving images (in all for-mats) and other graphical depictions incorporating my likeness and that of my child, in any and all media, whether now or hereafter created (the Content ). I hereby agree that all rights in and to the Content, including any copyright, are and shall remain the property of Jaguar Academy and Jaguar FC, free and clear from any claims by me or anyone acting on my behalf. Jaguar Academy s rights include, but are not limited to, the rights, in perpetuity, to: Use, re-use, publish, and re-publish the Content; Alter, modify or otherwise change the Content in any manner it desires; Combine the Content with textual matter and/or with other pictures and/or media; and use the Content for illustration, promotion, art, editorial, advertis-ing, trade publishing or any other purpose whatsoever. I hereby release, discharge and agree to hold harmless Jaguar Academy, its heirs, legal representatives and assigns and all persons acting under the its authority from any liability by virtue of its use of the Content or any changes or alterations made thereto. I HAVE READ AND AM IN AGREEMENT WITH THE TERMS OF THIS ACKNOWLEDGEMENT, RELEASE AND WAIVER AND UNDERSTAND THAT BY SIGNING THIS RELEASE I AM RELEASING AND WAIVING CERTAIN LEGAL RIGHTS. Dated this day of, 20 Child s Name (printed): Parent s Name (printed): Parent s Signature: