U15-U18 Competitive Program Packet. Player Packet Checklist

   

2015-16 U15-U18 Competitive Program Packet

 

Player Name:___________________________________________ Birthdate:_____/_____/_____

Age:_______ Gender: M / F Returning Player? Y / N Prior Team:____________________

Parent/Guardian Name(s):_______________________________________________________________

Address:_____________________________________________City:_________________ Zip:__________

Home Phone: (_____)_____________________ Cell Phone: (_____)_____________________________

Primary Email:_____________________________________________@___________________

Secondary Email:___________________________________________@___________________

Are you applying for Scholarship? → ​ YES​ or → ​ No​ (Please Circle One)

**Scholarship Applicants will be notified of Scholarship Award amount and Required Monthly payments as soon as possible.

Player Packet Checklist

__________ FINANCIAL OPTION/SCHOLARSHIP FORM __________ PARTICIPATION WAIVER

__________ MEDICAL RELEASE FORM

__________ **BIRTH CERTIFICATE & PLAYER PHOTO** (New players Only)

_________________________________________________________________________________________

_ ****Office Use Only****

Cash: $_________ Check #:_________/$_________ Credit Card: $________________

Signatures_______ Supporting Docs __________ New Player ___________

Notes____________________________________________________________________________________

capital fútbol club

since 1993 - formerly cascade fc

2015-16 U15-18 Competitive

Financial Option Form

Player Name _______________________________________ Team ________________________

Please choose one of the following payment options:

*​

I understand that failure to turn in payments may result in the holding of my players’ card until my account is current.

❏ Option 1 : SCHOLARSHIP: ​ I will submit a completed scholarship application with

supporting documentation and $75 nonrefundable annual membership fee, no later than November 30, 2015​ .

Program Fee @ 30% discount = 5 payments @ $70.00 = ​

$350.00

Program Fee @ 40% discount = 5 payments @ $60.00 = ​

$300.00

Program Fee @ 50% discount = 5 payments @ $50.00 = ​

$250.00

❏ Option 2 : PAYMENT IN FULL: ​ Payment in full receives a ​ $50 discount​ . I will pay the full

$525​

. This is $500 (​

program fee​

) + $75 (​

membership/registration fee​

) - $50 (​

^discount​

)

❏ Option 3 : MONTHLY PAYMENTS:​ by mail, in person, or by logging into my account online.

I realize that I am responsible to pay dues of ​

$100.00​

on the 1​

^st​

of each month for Dec. 2015 through April 2016. I will pay the nonrefundable $75 annual membership fee with my acceptance on a team. This is 5 payments @ $100.00 = ​

$500.00

❏ Option 4 : AUTOPAY:​ through CFC’s secure, automated system. My signature below, authorizes CFC to charge my credit card ​

$100.00​

on the 1​

^st​

of each month for Dec. 2015 through April 2016. I will pay the nonrefundable $75 annual membership fee with my acceptance on a team. This is 5 payments @ $100.00 = ​

$500.00

Credit Card Info:

Name on Card: ______________________________________ Visa or Mastercard (circle one) Billing Address: _________________________________________________ ZIP: ______________

Credit Card #: _______________________________________________ Exp Date: ____________

Signature: _____________________________________________ CCV#: _________________

***Please Review the Payment Term, Sign, and Date***

Scholarship Program 2015-16 U15-U18 Competitive Program

To provide all players with the opportunity to participate in

competitive soccer regardless of financial circumstances, CFC offers scholarships to qualified applicants in the amounts of 30%, 40%, and 50% of annual program fees.

In order to be considered for a scholarship, applicant must:

● Be registered with a CFC competitive team

● Have no outstanding balance from previous seasons

● Complete this application with ​supporting documentation​, returned to CFC office by ​November 30, 2015

● Provide at least ONE of the following documents for verification for 30% award:

○ Copy of current Oregon Trail Card

○ Proof of enrollment: Medicaid or Oregon Health Plan

○ Proof of enrollment: WIC program

○ School Letter showing enrollment in Free or Reduced Lunch program

○ Additionally, if you would like to be considered for a 40% or 50% award, a copy of most Recent Federal Tax Return (IRS form 1040, Page 1) is REQUIRED

● Pay the nonrefundable annual membership fee of $75 due at the time of application

● Agree to pay remaining program fees in 5 monthly payments, December 2015-April 2016

● Agree to fulfill 10 hours CFC volunteer requirement

Scholarships are awarded on the basis of information provided at the time of application. Awards of 30%, 40%, and 50% will be based on household income using HUD HOME program income tables for Salem.

**If a player joins the competitive program after the specified deadline, scholarship amounts and fees may be pro-rated.

Scholarship applications and supporting documentation must be received by the office within ​seven​ days of player joining the program for consideration.

Race - Please check the racial or ethnic identity of player:

White Black Hispanic Native American Asian/Pacific Islander

*your voluntary response helps CFC in applying for grants

Financial Information (Required)

Total Annual Gross Income earned by ALL Adults in your household: $_______________________

How many adults are supported by household income?:_________How many children?:________

Amount of Child Support received last year from a non-custodial parent?: $__________________

Amount of Social Security payment received last year: $_________________

To the best of my knowledge, the information and the attached documentation are a true and accurate

representation of my present financial standing. The deliberate misrepresentation of any information may result in the withdrawal of player's scholarship.

Player Name ________________________________Parent Name ______________________________

Parent Signature __________________________________________ Date _______________________

THE FOLLOWING ARE UNCONDITIONAL PAYMENT TERMS:

I understand that fees, down payment, and monthly payments are nonrefundable and nontransferable.​ If I am paying participation fees on the Monthly Payment Plan, I understand that payments are due the first of every month, and must be kept current (and current at the beginning of each new competitive season). I am responsible for making sure that my account is current throughout the year.

CANCELLATION OF AGREEMENT:

Enrollment, as specified within the Financial Option Form, may be cancelled by parents or guardians in writing, with forfeit/cancellation fee of $200, prior to the beginning of OYSA league play. If enrollment is canceled after the beginning of OYSA league play, parents or guardians financially responsible for the participant, are obligated to pay the full annual program fee.

WITHDRAWAL or DISMISSAL:

I understand and agree that in the event of withdrawal or dismissal for any reason whatsoever, whether voluntary or involuntary, for disciplinary, medical, or other reasons, CFC will sustain damage which is uncertain in amount, or difficult to prove, and for this reason we agree that we shall be liable for any fees paid in the full annual program fees, less any scholarship granted as liquidated damages. I also understand that enrollment is for the entire competitive program year and there are no participation fee allowances for absences. Additionally, if collection procedures are necessary, I understand that we WILL be liable for all fees, costs, and expenses including, but not limited to, legal fees, court costs, and interest.

League credentials (“player cards”, “player passes”, and/or roster associations) will not be released until all fees have been paid in full.

SUSPENSION IN CASE OF PAST DUE ACCOUNTS:

I understand that CFC may prohibit my child from participating in training and competition when an account is past due. I understand that CFC will give at least 48 hours notice if my player is not to participate because of nonpayment. The denial of attendance under these conditions will not relieve any of our obligations under this Financial Option Form. I will still be obligated to make all payments due, under the agreement.

NON-RETENTION:

I understand that CFC has a right to dismiss or deny re-enrollment of any player for unacceptable behavior, or for any other reason when, at the sole discretion of the board, that player’s continued presence is not in the best interest of either the club or the player. I also understand that the club reserves a right to dismiss or deny re-enrollment to a participant when, in the sole discretion of the board, the positive and constructive working relationship between club and parent that is so necessary to a player’s success and satisfaction and to the institution’s ability to serve others does not exist.

OTHER FEES:

Uniforms, tournament fees, coaches’ travel expenses, league fines, ETC. are billed and invoiced on a monthly basis.

CFC CULTURE:

We understand that each family enrolling a child in the competitive program at Capital Fútbol Club is required to contribute five (5) hours of volunteer service during the year to activities that benefit the club. Families participating in the CFC

scholarship program, will contribute ten (10) hours of volunteer service. If the child’s family elects not to contribute requires service, I understand that $50 will be billed to player accounts and given to the scholarship fund.

RETURNED CHECK AND PAST DUE ACCOUNT POLICIES:

CFC will charge a $25 service fee for any returned check. All returned checks must be made good by payment in money order, certified check, cash, or other guaranteed funds. After one returned check, CFC reserves the right to no longer accept personal checks.

In signing this Financial Option Form for the coming competitive season, I am agreeing to accept the rules and regulations of the club as stated in the current parent/player handbook, the payment options agreed to on the Financial Option Form, and the terms and conditions listed.

Player Name _____________________________________________

Parent Signature _________________________________________ Date _______________________

Notice is Given

Capital Fútbol Club (CFC) and its employees, agents, officers, directors, volunteers, members, managers,

participants, operators, and sponsors shall not be responsible directly or indirectly for the activities of the person participating in any Club sanctioned or sponsored game, tournament, event, or activity.

Voluntary Participation and Assumptions of Risk

All persons are informed and made aware that sports and physical activities may be inherently hazardous activities and participants in CFC activities are voluntarily participating in these activities with CFC with full knowledge of the dangers involved in such participation. The participants and/or undersigned individual agrees to accept any and all risks or property damage, personal injury, or death that results in the participation in CFC activities by the participant, now, or in the future. The participants and/or undersigned individual hereby release the named parties from any present or future claims, including active or passive negligence, for property damage, personal injury, or wrongful death arising from the participation in activities with CFC.

Covenant Not to Sue

The participants are notified, understand, and agree that they will not make a claim against, attach the property of, or sue the parties being released, for injury, damage, or death, resulting from the active or passive negligence, or other acts, howsoever caused, by any employee, agent, volunteer, or contractor of CFC as a result of the

participation of the participant in any CFC game, tournament, event, or activity.

Indemnity Agreement

The participant agrees to indemnify and defend the released parties against, and hold them harmless from, any and all claims, causes of action, damages, judgments, costs and expenses, including attorney fees which in any way arise from participation in CFC sanctioned or sponsored games, tournaments, events, or activities, including without limitation, the active or passive negligence, if any, of CFC and other parties. The participant shall defend, indemnify, and hold CFC, its officers, members, volunteers, employees, and agents harmless from and against any and all liability, loss, expense, including reasonable attorney fees, or claims for injury or damages arising out of the performance of this Agreement in proportion to and to the extent that such liability, loss, expense, attorney fees or claims for injury or damages are caused by or result from negligent or intentional acts or omissions of CFC, its officers, members, volunteers, agents, or employees.

Read and Understood

By agreeing, the participant has carefully read this agreement and fully understand its contents. The participant is aware that this is a release of liability, an agreement to assume risk, and agreement to indemnify the released parties, and an agreement to pay for damages that the undersigned willfully, negligently, or otherwise caused to the released parties. This participant is aware that this document creates legal obligations he/she owes to the released parties and signs the document of his/her own free will. I agree and represent that I understand the nature of soccer and related sport activities and that I am qualified in good health, and in proper physical condition to participate in such activity. I further agree and warrant that if at any time I believe conditions to be unsafe, I will immediately discontinue further participation in the activity.

Player Name _____________________________________________

Parent Signature _________________________________________ Date _______________________