Ayso Registration Form PDF Details

The Ayso Registration Form is a comprehensive document designed by the American Youth Soccer Organization (AYSO) to enroll participants in its soccer programs. It captures essential information, including the player's AYSO ID#, personal details, emergency contacts, and medical information, to ensure a safe and organized participation framework. The form also seeks details about the player's parents or guardians, emphasizing the organization's volunteer-driven nature by offering opportunities for adult involvement in roles such as coaching or refereeing. Further, it includes vital authorizations and agreements, acknowledging the risks associated with soccer, consenting to emergency medical treatments, and detailing the participant's insurance coverage. These crucial elements aim to safeguard participants and provide a clear understanding of the responsibilities and expectations from all parties involved. Additionally, the document outlines the AYSO's commitment to privacy, its insurance plans, and the importance of understanding concussion risks, reflecting the organization's dedication to the welfare and safety of its young athletes. Overall, the Registration Form acts as a key tool in facilitating a proactive and informed community within the AYSO's programs.

QuestionAnswer
Form NameAyso Registration Form
Form Length3 pages
Fillable?No
Fillable fields0
Avg. time to fill out45 sec
Other namesregistration ayso, ayso registration form, online ayso form, online form ayso

Form Preview Example

Player Registration Form

American Youth Soccer Organization

AYSO ID#:

www.ayso.org

 

PLEASE FILL IN ALL OF THE REQUESTED INFORMATION AND SIGN WHERE INDICATED. PRESS HARD. YOU ARE MAKING FOUR COPIES

 

Region Number

Division

Check If

 

 

Loc. Code

 

 

 

 

 

 

 

 

 

a VIP Player

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Player

 

First Name

 

 

 

 

 

 

Middle Name

 

 

 

Last Name

 

 

Suffix

 

Area Code

 

Telephone

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Nickname

 

 

 

Street Address

 

 

 

 

 

City

 

 

 

 

 

 

State

 

 

Zip Code

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Mailing Address (if different from Street address)

 

 

 

 

 

City

 

 

 

 

 

 

State

 

 

Zip Code

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Emergency Contact (other than parent)

 

 

 

Area Code

 

Emergency Telephone

 

Physician Name

 

 

 

 

Area Code

 

Physician Telephone

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Gender

 

 

Birthdate

 

 

 

 

Age

 

School Name

 

 

 

 

Family e-mail address

 

 

 

 

 

 

 

 

 

Boy

 

Girl

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Medical Insurance Carrier, Policy #

 

 

Siblings to play with:

 

 

 

Current injuries or minor physical

limitations or other medical condition the coach should know about:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Yrs of Experience

 

Height

 

Weight

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Region Specific Message:

Parent/Guardian #1 Father Mother Guardian

Last Name

First Name

Div.

First Name

 

 

Middle Name

 

 

 

 

 

Last Name

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Address (if different from Player)

 

 

City

 

 

 

 

 

 

 

 

State

Zip Code

 

e-mail address

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Employer

Area Code

Business/Cellular Telephone

Area Code

 

Home Telephone

 

 

AYSO is an all volunteer organization. I apply to:

Coach

Asst. Coach

 

 

 

 

 

 

 

 

 

 

 

 

 

Referee

Team Parent

Other:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

If you have not already done so, please complete and submit a volunteer application. And thank you in advance for volunteering

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Parent/Guardian #2

 

 

Father

 

Mother

 

 

Guardian

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

First Name

 

 

Middle Name

 

 

 

 

 

Last Name

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Address (if different from Player)

 

 

City

 

 

 

 

 

 

 

 

State

Zip Code

 

e-mail address

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Employer

Area Code

Business/Cellular Telephone

Area Code

 

Home Telephone

 

 

AYSO is an all volunteer organization. I apply to:

Coach

Asst. Coach

 

 

 

 

 

 

 

 

 

 

 

 

 

Referee

Team Parent

Other:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

If you have not already done so, please complete and submit a volunteer application. And thank you in advance for volunteering

Authorization, Disclaimer, Assumption of Risk and Waiver and Consent Agreements

EMERGENCY AUTHORIZATION: I, the undersigned parent or legal guardian of the above-named player, a minor (“Player”) hereby authorize each of the coaches, team parents, and/or other officials of AYSO to act as my agents in the capacity of activity supervisors and vehicle drivers, and I authorize each of them as well as the above-identified Emergency Contact to consent to medical, surgical or dental examination and/or treatment. (continued on reverse side)

I HAVE READ THE ABOVE EMERGENCY AUTHORIZATION, AND THE DISCLAIMER, ASSUMPTION OF RISK AND WAIVER, AND THE ACKNOWLEDGEMENT AND CONSENT AGREEMENTS PRINTED ON THE REVERSE SIDE OF THIS FORM, FULLY UNDERSTAND THE TERMS OF EACH, UNDERSTAND THAT I AND PLAYER HAVE GIVEN UP SUBSTANTIAL RIGHTS BY MY SIGNING THIS FORM AND AGREEING TO THESE TERMS, AND I SIGN THIS FORM FOR MYSELF AND ON BEHALF OF PLAYER AND AGREE TO THESE TERMS FREELY AND VOLUNTARILY AND WITHOUT INDUCEMENT.

Parent/Guardian Signature: ________________________________________________________ Date: _____________________

The AYSO Endowment Fund: The AYSO Endowment Fund is committed to bringing the AYSO experience to children who need financial help. If you would like to make a tax deductible contribution to assist in this effort, please call the Member Services Department at 800-872-2976 or send an e-mail message to endowment@ayso.org.

“PLAYSOCCER”, AYSO’s quarterly magazine is sent to every household. By e-mail and regular mail, AYSO sends other publications, information and special offers we think will be of interest to our members. If, for some reason, you do not wish to receive these other communications, please check this box.

DOB Verification

Check Number

Fee Charged

Amount Paid

This document contains confidential and/or proprietary information and is the property of the American Youth Soccer Organization.

c 2004 American Youth Soccer Organization Rev. 2012

Reorder #GS101-7

Disclaimer, Assumption of Risk and Waiver and Consent Agreements

I warrant and acknowledge that I am the parent or legal guardian of the player named on the reverse side of this application, a minor (“Player”) and that I am authorized on behalf of myself, Player and our heirs, assigns and next of kin, to hereby enter into the following agreements IN CONSIDERATION OF Player’s being able to participate in any way at practices, games or other activities (“EVENTS”) sanctioned by the American Youth Soccer Organization (“AYSO”).

DISCLAIMER, ASSUMPTION OF RISK AND WAIVER: I acknowledge that participation in soccer necessarily involves travel, play in adverse field conditions, contact with considerable force, and risk of severe, permanent physical injury including bruises, scrapes, strained, sprained or torn muscles, tendons or ligaments, broken bones, dislocation of joints, concussion, brain damage, nerve and spinal cord injury, paralysis and death. I WILLINGLY AND VOLUNTARILY ASSUME ALL SUCH RISKS. I willingly and voluntarily agree to comply with the stated and customary terms and conditions for participation and, if Player or I observe any concern in Player's readiness for participation in the EVENTS, I will remove him/her from participation and bring such concern to the attention of the nearest official immediately and also of the Regional Commissioner as soon as possible thereafter.

I HEREBY RELEASE, DISCHARGE AND AGREE TO HOLD HARMLESS, to the fullest extent permitted by law, AYSO, its players, employees, volunteers, officials, sponsors and other representatives and any and all owners, lessors, lessees or other persons or entities allowing, permitting or authorizing the use of facilities by AYSO and the agents, employees, officers and directors of said persons or entities (“RELEASEES”) from any and all claims, demands, costs, expenses and compensation arising out of or in any way related to an injury or other damage that may result to said participant or to members of my family or my household or individuals I invite or for whom I am otherwise responsible while participating in or present at any of the EVENTS, WHETHER ARISING FROM THE NEGLIGENCE OF THE RELEASEES OR OTHERWISE. I further acknowledge that AYSO is primarily administered by volunteers rather than paid professionals.

I further acknowledge and accept that this Disclaimer, Assumption of Risk and Waiver is intended to be as broad and inclusive as permitted by the laws of the state in which we live and agree that if any portion of this Disclaimer, Assumption of Risk and Waiver is deemed to be invalid, the remainder will continue in full legal force and effect.

ACKNOWLEDGEMENT AND CONSENT: I understand the terms of the Soccer Accident Insurance Plan are set forth in a pamphlet available from the Safety Director of my region or on-line at http:// www.ayso.org/resources/insurance/insurance_forms.aspx, as the same may be amended from time to time, and either I have read and understand the terms or I will do so before permitting Player to participate.

I further acknowledge that I have received the AYSO/CDC Parent/Athlete Concussion Information Sheet (also available online at http://www.ayso.org/resources/safety.aspx) which contains information related to a) signs and symptoms of a concussion; b) danger signs associated with a concussion; c) why athletes should report symptoms related to a concussion; and d) what should be done if a concussion is suspected. I agree to review the Parent/Athlete Concussion Information Sheet with my child (Player) and return a signed copy as indicated on the form to my child’s coach on my child’s first day of practice.

For both internal and external use, I acknowledge that AYSO may compile and use addresses and soccer photographs of Player consistent with the AYSO Privacy Policy set forth at http:// www.ayso.org/resources/legal/privacy_policy.aspx, as the same may be amended from time to time. I consent to such uses and hereby waive all rights to approval and compensation.

On behalf of my child (Player), myself and all members of my child’s family, I hereby agree to abide by the AYSO Bylaws, rules, regulations, policies and philosophies as available at http:// www.ayso.org/resources/governing_documents.aspx, and all decisions and directions of the Regional Board, Area and Section staff, and the National Board of Directors, and I understand that the Player or any member of the Player’s family may be removed from the program at any time with or without cause. I further agree that the Player has not been convicted of any crime as a minor nor does the Player have any known condition that might pose undue risk to other participants.

(Please signify your agreement with the foregoing by signing in the space indicated on the reverse side of this form.)

Parent/Athlete Concussion Information Sheet

A concussion is a type of traumatic brain injury that changes the way the brain normally works. A concussion is caused by bump, blow or jolt to the head or body that causes the head and brain to move rapidly back and forth. Even a “ding,” “getting your bell rung,”

or what seems to be a mild bump or blow to the head can be serious.

WHAT ARE THE SIGNS AND SYMPTOMS OF CONCUSSION?

Did You Know?

Most concussions occur without loss of consciousness

Athletes who have, at any point in their lives, had a concussion have an increased risk for another concussion.

Young children and teens are more likely to get a concussion and take longer to recover than adults.

Signs and symptoms of concussion can show up right after the injury

below after a bump, blow, or jolt to the head or body, s/he should

or may not appear or be noticed until days or weeks after the injury.

be kept out of play the day of the injury and until a health care

If an athlete reports one or more symptoms of concussion listed

professional, experienced in evaluating for concussion, says s/he

is symptom-free and it’s OK to return to play.

 

 

 

SIGNS OBSERVED BY COACHING STAFF

 

 

SYMPTOMS REPORTED BY ATHLETES

 

Appears dazed or stunned

 

 

Headache or “pressure” in head

Is confused about assignment or position

 

 

Nausea or vomiting

Forgets an instruction

 

 

Balance problems or dizziness

Is unsure of game, score, or opponent

 

 

Double or blurry vision

Moves clumsily

 

 

Sensitivity to light

Answers questions slowly

 

 

Sensitivity to noise

Loses consciousness (even briefly)

 

 

Feeling sluggish, hazy, foggy, or groggy

Shows mood, behavior, or personality changes

 

 

Concentration or memory problems

Can’t recall events prior to hit or fall

 

 

Confusion

Can’t recall events after hit or fall

 

 

Just not “feeling right” or “feeling down”

CONCUSSION DANGER SIGNS

In rare cases, a dangerous blood clot may form on the brain in a person with a concussion and crowd the brain against the skull. An athlete should receive immediate medical attention if after a bump, blow or jolt to the head or body s/he exhibits any of the following danger signs:

One pupil larger than the other

Is drowsy or cannot be awakened

A headache that not only does not diminish, but gets worse

Weakness, numbness, or decreased coordination

Repeated vomiting or nausea

Slurred speech

Convulsions or seizures

Cannot recognize people or places

Becomes increasingly confused, restless, or agitated

Has unusual behavior

Loses consciousness (even a brief loss of consciousness should be taken seriously)

WHY SHOULD AN ATHLETE REPORT

THEIR SYMPTOMS?

If an athlete has a concussion, his/her brain needs time to heal. While

an athlete’s brain is still healing, s/he is much more likely to have another concussion. Repeat concussions can increase the time it takes to recover. In rare cases, repeat concussions in young athletes can result in brain swelling or permanent damage to their brain. They can even be fatal.

Remember

Concussions affect people differently. While most athletes with a concussion recover quickly and fully, some will have symptoms that last for days, or even weeks. A more serious concussion can last for months or longer.

WHAT SHOULD YOU DO IF YOU THINK YOUR ATHLETE HAS A CONCUSSION?

If you suspect that an athlete has a concussion, remove the athlete from play and seek medical attention. Do not try to judge the severity of the injury yourself. Keep the athlete out of play the day of the injury and until a health care professional, experienced in evaluating for concussion, says s/he is symptom-free and it’s OK to return to play.

Rest is key to helping an athlete recover from a concussion. Exercising or activities that involve a lot of concentration, such as studying, working on the computer, or playing video games, may cause concussion symptoms to reappear or get worse. After a concussion, returning to sports and school is a gradual process that should be carefully managed and monitored by a health care professional.

It’s better to miss one game than the whole season. For more information on concussions,

visit: www.cdc.gov/Concussion.

Student-Athlete Name Printed

Student-Athlete Signature

Date

 

 

 

 

 

Parent or Legal Guardian Printed

Parent or Legal Guardian Signature

Date

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Stage # 1 of filling in ayso registration form

2. Just after completing the last part, go on to the next stage and complete the necessary details in these blanks - First Name, Middle Name, Last Name, ParentGuardian Father Mother, Address if different from Player, City, State, Zip Code, email address, Employer, Area Code, BusinessCellular Telephone, Area Code, Home Telephone, and AYSO is an all volunteer.

Filling out segment 2 of ayso registration form

Be extremely careful while filling out Zip Code and Area Code, as this is the part in which many people make errors.

3. In this particular stage, review I HAVE READ THE ABOVE EMERGENCY, ParentGuardian Signature Date , The AYSO Endowment Fund The AYSO, PLAYSOCCER AYSOs quarterly, DOB Verification, Check Number, Fee Charged, Amount Paid, This document contains, c American Youth Soccer, and Reorder GS. All of these should be filled out with utmost accuracy.

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ayso registration form conclusion process detailed (portion 4)

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