+++ ATTENTION SOCCER TEAM MANAGERS +++ Please read this memo BEFORE submitting your Spring 2015 Santa Monica Adult Soccer Team Registration. For proof of Santa Monica Residency, each player on the team MUST provide a VALID California Driver License or California ID with a Santa Monica Address along with the following: a CURRENT dated copy of a utility bill either a: cable, phone, electricity or gas bill. The address on the California Driver License or California ID should match the address on the utility bill. Santa Monica residency and work proof is required for every new registration season regardless if you have provided it in a previous season or not. Incomplete registrations will NOT be held in the office. We will only accept complete registrations. A complete registration means the following three items: A completed registration form with payment provided (either a check made out to: CITY OF SANTA MONICA or credit card with signature.) A completed roster. If your players have played in our league previously you must provide their Activity Passport ID number in the roster next to their name. If they are new players we require them to sign a liability waiver form and get an Activity Passport card. (You do not need to provide copies of signed waiver forms if players have previously signed the form and have their ID card.)** A forfeit bond --PERSONAL CHECK ONLY (made out to: SMASL MANAGEMENT in the amount of $80.00 for 7vs 7 or $320 for 11 vs 11 teams) **Please do not send players to the Community Sports Office to get their ID cards unless your team has been confirmed to play in the new season. Player s names must be on the team roster before they come in to get their cards. Only Team Managers can make changes to a roster: updated rosters must be in writing and sent to the office either by fax at 310-452-9407 or in person. Please note the office hours for soccer ID Cards or Roster Changes: Monday 12pm- 2pm & 4pm-8pm, Tuesday & Thursday 4pm-8pm, Sunday 12pm-8pm If enrollment exceeds league capacity in a division, teams interested in that division, with lower level priority status (most commonly Priority 3 status) will be invited to an open forum drawing to determine which teams will be accepted in the available slots, not already filled by the higher priority status teams in that division. The drawing will take place at a time and place to be determined by the league directors and City staff. Only teams that have completed registration forms will be allowed to participate in the process. Thank you for your understanding. If you have any questions please contact: Anthony Carpowich, Supervisor of the Santa Monica Adult Soccer League at 310-458-8237.
SANTA MONICA ADULT SOCCER LEAGUES SPRING SEASON 2015 Team Registration Form Registration from December 1, 2014 until December 12, 2014 Team Name: (Team name should not be offensive to youth) Team Manager Name: Address: Eve Ph: Day Ph: Cell Ph: Email Address: Team Fees and Make-up Weekday evenings, 14 week season, 7 vs. 7 players Maximum of 14 players on each team. $708.40 At least 60% players must be residents to be considered a priority one team. $796.95 At least 60% players must be residents and/or people who work in Santa Monica to be considered a priority two team. $885.50 All other teams are considered priority three teams. Saturdays, 10 week season, 7 vs. 7 players maximum of 14 players on each team. $506.00 at least 60% players must be residents to be considered a priority one team. $569.25 At least 60% players must be residents and/or people who work in Santa Monica to be considered a priority two team. $632.50 All other teams are considered priority three teams. Sundays, 12 week season, 11 vs. 11 players maximum of 24 players on each team. $1380.00 At least 60% players must be residents to be considered a priority one team. $1560.00 At least 60% players must be residents and/or people who work in Santa Monica to be considered a priority two team. $1725.00 All other teams are considered priority three teams. Indicate League Category: *Please check off all possible days you can play* Monday 7 vs. 7 Women s Co-ed Tuesday 7 vs. 7 Men s Wednesday 7 vs. 7 Women s Co-ed Thursday 7 vs. 7 Men s Friday 7 vs. 7 Men s Co-ed Saturday 7 vs. 7 Men s Women s Co-ed Saturday 7 vs. 7 Men Over 50 Men Over 40 Men Over 30 Saturday 7 vs. 7 Coed Over 50 Coed Over 40 Coed Over 30 Saturday 7 vs. 7 Women Over 50 Women Over 40 Women Over 30 11 vs. 11 Sunday League Men s Women s Co-ed Team Skill Level: Beginner Intermediate Advance *If there are not enough teams to fill a day of play, teams will be combined to the most requested day. **We cannot guarantee your team their requested day of play. However, please check off your team preference as we will use our priority system to determine each team s day of play.
SANTA MONICA ADULT SOCCER LEAGUES SPRING SEASON 2015 Team Registration Payment Form Registration from December 1, 2014 until December 12, 2014 Team Name: (Team name should not be offensive to youth) Team Manager Name: Fee Amount Enclosed Payment Method $ Check Make check payable to City of Santa Monica Credit Card Amex MasterCard Visa Discover Name on Card: Card Number: / / / Card Expiration Date: Card Holder Signature: Player Registration Forms Must Accompany Team Registration Forms Separate Payment Bond: This payment must be a personal check payment made out to: SMASL Management. $80 forfeit bond for 7vs7 and $320 forfeit bond for 11vs11. This bond will be returned at the end of the season if your team does not forfeit. Referee fees are payable to the referee each week. Referee fees of $20 per team per game for 7 vs. 7 and $80 per team per game for 11 vs. 11 Send Completed Application Packets to: Community Sports Office, 1401 Olympic Blvd., Santa Monica, CA 90404 City Use Only Date Received: By: Payment Received $
Adult Soccer Leagues SPRING 2015 Team Roster Team Name: (Team name should not be offensive to youth) Team Roster Name Activity Passport # Male Female 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 14. 15. 16. 17. 18. 19. 20. 21. 22. 23. 24. A maximum of 14 players are allowed for 7 vs. 7 play, a maximum of 24 players are allowed for 11 vs. 11 play. Player Registration and Release of Liability forms must be on file with the City of Santa Monica. A City issued photo ID card (Activity Passport) is required for all players. Activity Passport photos are taken at the Community Sports Office at Memorial Park 1401 Olympic Blvd., See memo for office hours City Use Only Date Received: By: # of Residents: # of NR who work in SM: # Others: Proof of Residency and Employment Received? Priority Level: 1 2 3 Player Registration and Release of Liability Forms Received on All Players?
SANTA MONICA ADULT SOCCER/FUTSAL LEAGUES PLAYER RELEASE OF LIABILITY AND REGISTRATION FORM TEAM NAME TEAM MGR NAME Player Full Name Male Female Date of Birth Age Home Address Apt.# City Zip Code Email Address Home Phone ( ) Alternate Phone ( ) If you are not a Santa Monica resident, but work in Santa Monica, please complete the following: Employer Name Phone ( ) Employer Address City Zip Code Updated contact information is to be provided to the Community Sports Office within 30 days of any changes. WAIVER, RELEASE AND ASSUMPTION OF RISK: In consideration of my participation in the Santa Monica Adult Soccer/Futsal Leagues, I hereby waive, release and discharge all claims for damages for death, personal injury, or property damage which may occur as a result of my participation in the soccer/futsal league or any activity incident thereto. This release discharges in advance the City of Santa Monica, Santa Monica/Malibu Unified School District (SMMUSD), its officers, agents, servants, and employees, game officials and referees (hereinafter referred to collectively as CITY ) from liability even though that liability may arise out of the CITY S active or passive negligence or carelessness. I acknowledge that some recreational activities, including soccer/futsal, involve an element of risk or danger of accidents, injury and even death, and knowing those risks, I freely and voluntarily assume the risk of injury and/or death and I promise not to sue or exercise any legal right to seek damages from CITY. By this Agreement, I also intend to waive, release and discharge all claims for personal injury, death or property damage caused by the condition of the soccer field/ Futsal field/gym or any equipment thereon including goals, nets, flags, balls, markers or cones. I understand that this WAIVER, RELEASE and ASSUMPTION OF RISK form will remain on file with the CITY and that it will apply to the current season as well as my participation in future seasons in the Adult Soccer/ Futsal Leagues. I certify that I have no medical condition that would cause participation in the soccer/futsal leagues to increase the risk of hazard to my health. In addition, I authorize the CITY to provide or cause to be provided such medical treatment that may be necessary or appropriate if I am injured while participating in the soccer/futsal league. 1 of 2 Player Initials
I hereby consent to the photographing, recording or reproduction in any other manner (including the use of videotapes and audiotapes) of my or my child s likeness, voice and/or soccer/futsal activities and further authorize CITY to make unlimited use of such reproductions, including but not limited to, broadcasting to the public of the reproductions over radio and television stations. I understand that I will not receive any monetary compensation, now or in the future, for participant. I hereby release and hold harmless CITY from any claims that may result from the use of such reproductions. I have read and understand the rules, guidelines and bylaws of the Santa Monica Adult Soccer/Futsal League and agree to abide by them. In addition, I understand that good sportsmanship is required and that the League rules prohibit fighting, taunting, spitting, making verbal threats to players, referees or staff and that such conduct will not be tolerated and is cause for expulsion from the league. I understand that failure to abide by them may result in my expulsion from the game and or the League. Player Printed Name Player Signature Date Required for players under 18 years of age: Parent Legal Guardian Printed Name Signature Date Activity Passport A City issued photo ID card (Activity Passport) is required for all players. Activity Passport photos are taken at the Community Sports Office at Memorial Park, 1401 Olympic Blvd., Mon 12pm-2pm & 4pm-8pm, Tue & Thu 4pm-8pm Sun 12pm-8pm Must attach proof of Santa Monica residency or proof of employment in Santa Monica for priority team registration. STAFF USE ONLY 7 vs. 7 Men s 7 vs. 7 Women s 7 vs. 7 Co-ed 11 vs. 11 Men s 11 vs. 11 Women s 11 vs. 11 Co-ed Employee Signature Date 2 of 2