2020-2021 HFC Competitive Program Player and Family Financial Commitment Form

11U-14U Boys or Girls 2020-2021 Competitive (Classic) Program Financial Statement

Special 2020-21 note: Upon acceptance to the 2020-21 HFC Club Competitive program, families will be asked

to make a commitment deposit of $230. NO OTHER FEES will be charged or required at that time. Due to the

fluid nature of the Covid-19 pandemic and its possible effects on the season, all other payments will be on

hold until there is certainty within the club that programming can resume.

Once that occurs, any appropriate fee changes for HFC or team fees will be calculated and payment schedules

will be established for the full fall and spring seasons. The information below supposes that training, matches,

and all programming is minimally affected by mandated closures:

11U-14U Competitive Program Fees for 2020-2021 are as follows:

HFC Club Fees: $1430 ($715/season)

Club Fees cover coaching, fields, facility rental, facility maintenance, equipment, club and state

registration, insurance and other administrative costs. Training schedules and program descriptions

can be found on the programs page at www.abysa.org.

HFC Team Fees: $30-$50/month

Team fees cover referee match fees, tournament entry fees, coaches travel expenses, and similar

charges. The first $200 of your team fees plus the player registration fee of $30 are collected at

acceptance. These amounts are not refundable. The balance of team fees is paid directly to the team.

Team budgets will vary.

Other expenses and/or commitments:

Uniform: The 2019-2020 year marks the first year in our two-year uniform cycle. All players must

purchase a uniform kit. A link to the uniform purchase site (Lloyd’s Soccer) will come from the HFC

travel program administrator and be purchased directly by the family. The basic uniform package is

approximately $260 and includes two jerseys, one pair of shorts, two pairs of socks, and an optional

gear bag and warm-up set. Other items, including a rain jacket, sweatshirts, and fan gear can also be

purchased for an additional cost.

Service: The Highland Football club is the competitive program wing of the Asheville Buncombe Youth

Soccer Association, a non-profit organization that requires parents and families to fully participate in

the program. Numerous projects require additional labor and assistance-and our club requires each

family to provide (4) hours of service to the club each year. Further information about the service

program can be found on the ABYSA website.

Marathon Games Fundraiser: Participation in the May event benefits all players and families. Details

on the program can be found online at www.abysa.org.

Player Name: Birth Date:

Please initial each item below and sign:

_____ All payments are expected to be paid on time to ABYSA and to the team treasurer. Payments (HFC or

team fees) in excess of 30 days past due may result in the surrender of a player’s NCYSA player pass. Players

will not be allowed to practice or play in games until the card is reinstated.

_____ Financial Aid is available for those families that demonstrate need. No full scholarships are provided.

Applications must be received in the ABYSA/HFC office by July 15th for fall applications. Documentation will

be required with your application for financial aid, and awards cannot be considered until the acceptance

deposit is made for the player.

_____ The full responsibility for payment is accepted by the parent signing below. If there is more than one

parent who is financially responsible for player’s fees, both parents MUST sign or each must send in a separate

form.

_____ I agree that by signing this Player Commitment & Financial Contract the player is committed to the

Highland Football Club/ABYSA for the NCYSA seasonal year beginning September 1, 2020 and ending August

31, 2021. By signing this form I understand that I am not only binding the player to the club, but I am also

making a commitment to fully meet all financial obligations to the club and team for the year except in

cases of injury, sickness or if our family relocates out of the area.

Parent/Guardian #1: Date:

Parent/Guardian #2: Date:

HFC monthly payment plan Due at acceptance: $230.00

July 15: $143.00 December 15: $143.00

August 15: $143.00 January 15: $143.00

September 15: $143.00 February 15: $143.00

October 15: $143.00 March 15: $143.00

November 15: $143.00 April 15: $143.00

NORTH CAROLINA YOUTH SOCCER ASSOCIATION WAIVER (To be given to your local association)

20 ____ - 20____ NCYSA NCYSA Policy #

Excess policy to any valid and collectible PO Box 18229 insurance. If there is no primary insurance

on insurance on a player, this policy Greensboro, NC 27419 primary after the deductible. 336.856.7529

Player First Name M Initial Last Name Full Association Name Jersey # (AS APPEARS ON BIRTH CERTIFICATE)

[ ] Academy [ ] Challenge [ ] Classic [ ] Recreation [ ] Male [ ] Female

Birth Date Level Sex

Address of Player City State Zip

Parent/Legal Guardian Full Name Home Phone Work Phone Cell Phone

Additional Person to Contact in an Emergency Address Home Phone Cell Phone

Date of Last Tetanus Shot Medications now being taken

_____________________ Player is Allergic to these Medications and Substances

_________ List any Unusual Health Information Email for soccer information

I (we), the undersigned, residing in the county of , state of _________, the parents/legal guardian of the above Registrant, a minor, who resides with us, do hereby declare our intent to allow that child to practice, train, play and participate in all soccer-related activities with the above-mentioned soccer team affiliated with the North Carolina Youth Soccer Association and the United States Youth Soccer Association.

I (we) agree that we and the Registrant will abide by the rules of the USYS, its affiliated organizations and sponsors. Recognizing the possibility of physical injury associated with soccer and in consideration for the USYS and NCYSA accepting the Registrant for their soccer programs and activities (the “ Programs”), we hereby jointly and severally release, discharge and/or otherwise indemnify the USYS, NCYSA, their affiliated organizations and sponsors, their employees and associated personnel, including the owners of fields and facilities utilized by the Programs, against any claim by or on behalf of the Registrant as a result of the Registrant’s participation in the Programs and/or being transported to or from the same, which transportation we hereby authorize.

I (we) further, jointly and severally, as parents and legal guardians of the Registrant, release, discharge, and agree to hold harmless and indemnify the above-named individuals or any of the designated coaches of the above Team from any and all liability, claims or demands arising from the Registrant participating in the Programs with the above Team specifically to include any and all claims for personal injuries sustained while present or participating in the Programs or traveling to or from events in the Programs or while on trips sponsored by or in conjunction with the Programs.

In addition, I (we) do hereby authorize any one of the designated adults of the Team, if after a reasonable attempt has been made to reach a parent or guardian to obtain consent or if sound medical practice decrees that there is not time to make such an attempt, to consent to any x-ray examination, anesthetic, medical or surgical procedure, treatment, and/or hospital care, to be rendered to the Registrant under the general or special supervision of and/or on the advice of any physician, surgeon or dentist duly licensed to practice.

The undersigned have read and fully understand and agree to the foregoing. In addition, NCYSA and the undersigned agree that this agreement may be executed by electronic signatures as provided in Chapter 66 of the North Carolina General Statutes.

Insurance Information: Name of Insurance Company: ___________

Parent/Legal Guardian Signature

ID Number:

Confirmation Number: __________ ___________________________________ Date

NCYSA and/or ABYSA COMMUNICABLE DISEASE

RELEASE OF LIABILITY AND ASSUMPTION OF RISK AGREEMENT

In consideration of being allowed to participate in any way in any North Carolina Youth Soccer

Association, Inc. (“NCYSA”) and/or Asheville Buncombe Youth Sports Association (“ABYSA) related sanctioned

events and activities I, the undersigned participant and parent (or legal guardian) acknowledge, appreciate, and

agree that:

By participating in NCYSA and/or ABYSA 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, 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, illness or other loss that I may sustain in

connection with such Communicable Diseases.

I, for myself and 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 NORTH CAROLINA YOUTH SOCCER ASSOCIATION, INC. and/or ABYSA, and its officers, directors, officials, agents, representatives, employees, other participants, sponsors, advertisers, and, if applicable, owners and lessors of premises upon which NCYSA and ABYSA 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 North Carolina, 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.

Print Participant Name

X Participant’s Signature/Name Age Date

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 the above participant, and that I have read this 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 NCYSA and/or ABYSA related events or activities as provided herein, EVEN IF ARISING

FROM THE NEGLIGENCE OF THE RELEASEES, to the fullest extent permitted by law.

X Parent/Guardian Signature Date Emergency Phone Number(s)

CONCUSSION INFORMATION FOR HFC PLAYERS &

PARENTS/LEGAL CUSTODIANS Keep this form as a reference for you and your child.

What is a concussion? A concussion is an injury to the brain caused by a direct or indirect blow to the head. It

results in your brain not working as it should. It may or may not cause you to black out or pass out. It can happen

to you from a fall, a hit to the head, or a hit to the body that causes your head and your brain to move quickly back

and forth.

How do I know if I have a concussion? There are many signs and symptoms that you may have following a

concussion. A concussion can affect your thinking, the way your body feels, your mood, or your sleep. Here is what

to look for:

Thinking/Remembering: Difficulty thinking clearly; taking longer to figure things out; difficulty concentrating; or

difficulty remembering new information.

Physical: Headache; fuzzy or blurry vision; sick to your stomach/queasy; vomiting/throwing up; dizziness; balance

problems; or sensitivity to noise or light.

Emotional/Mood: Irritability-things bother you more easily; sadness; being more moody; feeling nervous or

worried; or crying more.

Sleep: Sleeping more than usual; sleeping less than usual; trouble falling asleep; or feeling tired.

What should I do if I think I have a concussion? If you are having any of the signs or symptoms listed above, you

should tell your parents, coach, or athletic trainer so they can get you the help you need. If a parent notices these

symptoms, they should inform the coach or athletic trainer.

When should I be particularly concerned? If you have a headache that gets worse over time, you are unable to

control your body, you throw up repeatedly or feel more and more sick to your stomach, or your words are coming

out funny/slurred, you should let an adult like your parent or coach know right away, so they can get you the help

you need before things get any worse.

What are some of the problems that may affect me after a concussion? You may have trouble in school or even

with activities at home. If you continue to play or return to play too early with a concussion, you may have long

term trouble remembering things or paying attention, headaches may last a long time, or personality changes can

occur. Once you have a concussion, you are more likely to have another concussion.

How do I know when it’s ok to return to physical activity and my sport after a concussion? After telling your

coach, your parents, and any medical personnel around that you think you have a concussion, you will probably be

seen by a doctor trained in helping people with concussions. Your parents can help you decide who is best to treat

you and help to make the decision on when you should return to play or practice. HFC wants to make sure you do

not return to play before it is safe.

You should not return to play or practice on the same day as your suspected concussion. You should not have

any symptoms at rest or during/after activity when you return to play, as this is a sign your brain has not

recovered from the injury.

Carolina Athletic Trainers’ Association, Brain Injury Association of North Carolina, North Carolina Neuropsychological Society, and North Carolina

High School Athletic Association. Table is adapted from the Centers for Disease Control and Prevention (http://www.cdc.gov/concussion/)

2020-21HFC Player & Parent/Legal Custodian Concussion Statement

If there is anything on this sheet that you do not understand, please ask an adult to explain or

read it to you. This form must be completed for each HFC Player, even if there are multiple

club members in each household.

HFC Player Name: ____________________________________________________________________

Parent/Legal Custodian Name(s): ________________________________________________________

Player: _____ Parent: _____ we have read the HFC Player & Parent/Legal Custodian Concussion Information Sheet.

After reading the information sheet, I am aware of the following information:

Player: _____ Parent: _____ A concussion is a brain injury, which should be reported to my parents, my coach(es), or a medical

professional if one is available.

Player: _____ Parent: _____ A concussion can affect the ability to perform everyday activities such as the ability to think,

balance, and classroom performance.

Player: _____ Parent: _____ A concussion cannot be “seen.” Some symptoms might be present right away. Other symptoms

can show up hours or days after an injury.

Player: _____ Parent: _____ I will tell my parents, my coach, and/or a medical professional about my injuries and illnesses.

Player: _____ Parent: _____ If I think a teammate has a concussion, I should tell my coach(es), parents, or medical professional

about the concussion.

Player: _____ Parent: _____ I will not return to play in a game or practice if a hit to my head or body causes any concussion-

related symptoms.

Player: _____ Parent: _____ I will/my child will need written permission from a medical professional trained in concussion

management to return to play or practice after a concussion.

Player: _____ Parent: _____ Based on the latest data, most concussions take days or weeks to get better. A concussion may not

go away right away. I realize that resolution from this injury is a process and may require more than one medical evaluation.

Player: _____ Parent: _____ I realize that ER/Urgent Care physicians will not provide clearance if seen right away after the

injury.

Player: _____ Parent: _____ After a concussion, the brain needs time to heal. I understand that I am/my child is much more

likely to have another concussion or more serious brain injury if return to play or practice occurs before concussion symptoms

go away.

Player: _____ Parent: _____ Sometimes, repeat concussions can cause serious and long-lasting problems.

Signature of Student-Athlete Date Signature of Parent/Legal Custodian Date