"*" indicates required fields Step 1 of 5 20% Parent/Guardian InformationParent/Guardian #1 Name* First Last Relation to Player(s)*Email* Phone 1*Phone 1 Type*Phone 2Phone 2 TypeParent/Guardian #2 Name First Last Relation to Player(s)Email Phone 1Phone 1 TypePhone 2Phone 2 TypeChild's Primary Address* Street Address Address Line 2 City State AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific ZIP Code Emergency Contact InformationEmergency Contact #1* First Last Phone 1*Phone 2Emergency Contact #2* First Last Phone 1*Phone 2Medical/Hospital InsuranceMedical/Hospital Insurance Company*Medical/Hospital Insurance Company Phone*Policy Holder’s Name*Policy Number* Player InformationNumber of Players*1234Player 1Name* First Last Birthdate* MM slash DD slash YYYY Gender* Male Female Team*Alergies*Other Medical Conditions*Physician*Physician Phone #1*Physician Phone #2Player 2Name* First Last Birthdate* MM slash DD slash YYYY Gender* Male Female Team*Alergies*Other Medical Conditions*Physician*Physician Phone #1*Physician Phone #2Player 3Name* First Last Birthdate* MM slash DD slash YYYY Gender* Male Female Team*Alergies*Other Medical Conditions*Physician*Physician Phone #1*Physician Phone #2Player 4Name* First Last Birthdate* MM slash DD slash YYYY Gender* Male Female Team*Alergies*Other Medical Conditions*Physician*Physician Phone #1*Physician Phone #2 Player ContractCongratulations on being selected to join Northwest Iowa Soccer Club Competitive Soccer Program (hereinafter “NWISC”) for the 2025-26 season! The season runs from August 2025 through July 2026. With accepting a position with the NWISC we would like to ensure you understand the obligations and commitments of being a valued member. Please initial the points below to acknowledge your understanding of these expectations, then sign and date the last page of this form. U10 – U14 Fee NWISC Fee (US Club Soccer Player Card, Insurance, Admin Fee) $175.00 Coaching Fees $360.00 Indoor Facility (November-March indoor facility rent for practices) $140.00 Field Maintenance $115.00 Total Soccer Fees $790.00 Fall Tournament #1 $85.00 Fall Tournament #2 $85.00 Spring/Summer Tournament #3 $85.00 Spring/Summer Tournament #4 $85.00 Spring/Summer Tournament #5 $85.00 Spring/Summer Tournament #6 $85.00 Total Tournament Fees $510.00 Overall Total $1,300.00 $35.00 additional convenience fee if making monthly payments via credit card. $35.00 discount available if paying in full and forms are returned by 8/1/25. Note: Any additional tournaments or friendlies that players attend are an extra cost to the players as noted in the player contract. The registration fee covers the following: Coaching fees Tournament fees US Club Soccer fees (player card) and US Soccer Federation fees Indoor facility rental fees Field maintenance fees Overhead costs, including: insurance, website expenses, coaching tools, etc. Each player will be responsible for the entire registration fee even if the player leaves NWISC before the end of the year as NWISC incurs these expenses even if the player decides to leave the team.B. Tournament fee NWISC plans to attend six tournaments as a club (over the course of the season in the fall and spring/summer). The fee to attend each tournament is $85 per player as indicated in the fee schedule listed above. This fee includes the tournament fees, costs incurred by the coaches in attending the tournaments including but not limited to lodging expenses and travel costs, such as mileage. *** Please note that we are working on the tournament schedule. Some of the tournament dates will be tentative dates as most tournaments have not posted their official dates yet. If the team participates in a tournament, this portion is non-refundable even if you do not attend the tournament.C. Additional tournaments/friendlies. This is any additional tournament or friendly, other than those listed above at letter “B”, that are added over the course of the season. Players are not required to participate in these additional contests but if you agree to play and have been invoiced, you will be responsible to pay the invoice in full whether you participate or not. Fees for these will be divided equally between each player that agrees to play. Invoices are to be paid manually by the parent/guardian and are due on receipt. Invoices not paid within 30 days from invoice date will incur a 3% monthly finance charge and the player can be asked to sit out of future practices and tournaments until the balance is paid.D. Fee payment (Please submit payment with contract.) Registration tournament fees: There are three payment options for the fees: Pay in full ($35 discount for paying in full). Recurring Charge (monthly automatic withdrawal) via (*)credit card or bank account; Scholarship (additional information will be required to see if eligible; email registrar@nwisoccer.com – inquiries must be made by 8/1/25 and completed scholarship form submitted by 8/15/25) (*) Please note that if making payment via credit card, an annual max convenience fee of $35 will apply. Please circle your payment method: Pay In Full Recurring Charge Scholarship Before a player is able to participate in practice or tournaments, the parent/guardian needs to complete one of the three payment options and the payment and/or authorization form must be received by NWISC. A return check fee of $25 will be charged for any check that is returned for insufficient funds. Player’s granted scholarships may have additional obligations to NWISC that are conditions of the scholarship.E. Financial obligations and payments in a timely manner. Player and parent/guardian understand that accepting the position offered and completing the registration documents obligates them to pay the full registration fee provided in the fee schedule listed above. It is the player and parent’s/guardian’s obligation to pay the registration fee in full, after the expiration of the fifteen (15) day grace period, regardless of whether the player later leaves NWISC prior to the end of the season. Player and parents/guardians understand that failure to fulfill their financial obligations to NWISC will result in the player’s pass being taken away to prevent competing in practices and games. The player will be placed in “Not in Good Standing” with ISA, which will result in the player’s playing privileges being suspended until all the contract obligations are fulfilled. Further actions will be taken if necessary.F. Missed training sessions and games. Player and parent/guardian understand that the player is being accepted by NWISC as part of a team and absences make it difficult for other players to benefit from the NWISC’s training and games. It is known that situations arise that cause a player to miss a session or a game. If a situation arises, it is very important that the player and parents/guardians let the team manager and coach know they will not be at the session or game with as much notice as possible. If excess absences occur, a player’s playing time may be affected.G. Injuries If an injury occurs and a player cannot play for a two month period, fees will continued to be paid. If an injury occurs lasting over two months, fees will no longer need to be paid.H. Time to rescind this contract. Player and parent/guardian shall have fifteen (15) days from signing this contract to rescind it for any reason without penalty and receive a full refund of all fees paid to NWISC. After the expiration of the fifteen (15) day period player and parents/guardians will be required to pay the entire amount specified in fee list before being allowed to transfer to another team or NWISC.I. Player and parent conduct. Players and their parent/guardian will conduct themselves in accordance with NWISC, ISA, US Club Soccer, USSF, and FIFA rules at all times, or will be subject to disciplinary action.J. Other NWISC information and requirements. Player and parent/guardian understand that since this is a competitive environment, there is NO guarantee of minimum playing time. There is a 24 hour “No Contact Rule” in place after games regarding contact with a coach, face to face, via e-mail, or phone after the game. Everyone is expected to follow the correct protocol if a meeting is desired for conflict resolution with the coach.K. Hotel policy When the club attends a tournament all members represent not only NWISC but also our communities and our families. Player and parent/guardians understand that conduct at a hotel not only affects them personally but also their teammates and other patrons and staff of the hotel. The hotel conduct guide is as follows:Follow posted hotel rules.Be respectful to others and the property.Quiet time is 10:00pm. All players are to be in their appointed rooms by 10:15pm.No running or rough housing in any area of the hotel.Children need to be supervised.Public areas are for the courtesy of all and ask that you use good judgment by keeping noise to a reasonable level and know that public areas are to be picked up.Player 1 Initials*Player 2 Initials*Player 3 Initials*Player 4 Initials*Parent/Guardian Initials* US Club Soccer Consent & Liability WaiverUS Club Soccer Registration Consent*In signing below, I hereby consent to the above-named member organization/club registering me or my child or guardian, as applicable, with US Club Soccer. I understand that a player may be registered to only one US Club Soccer member organization/club at any time. I agree to the US Club Soccer Registration Consent.Medical Treatment Authorization and Liability Waiver/Release*I hereby give my consent, on my own behalf or on behalf of my child or guardian, as applicable, to have an athletic trainer, coach, team manager, emergency medical technician, physician, nurse, dentist, or other healthcare professional and, in each case, their associated personnel provide the player identified above with medical assistance and/or treatment and agree to be financially responsible for the cost of such assistance and/or treatment. I understand treatment for injury will be based, at least in party, on information provided herein. I hereby authorize emergency transportation of the player, at player or parent/guardian’s expense, to a healthcare facility should an individual listed above consider it to be warranted. I acknowledge and understand that certain risks of injury (including, but not limited to, concussions, other serious bodily injury or death) are inherent in playing soccer. These types of injuries may result from the player’s actions, the actions or inactions of others, or a combination of both. In signing below, I certify that the player received all necessary medical clearances to participate fully in all US Club Soccer programs without restriction or condition. To the maximum extent permitted by law, I hereby agree to release, waive, hold harmless and indemnify the member organization, the National Association of Competitive Soccer Clubs (dba US Club Soccer), its agents, contractors and sponsors, U.S. Soccer and its affiliated organizations, and the employees and associated personnel of these organizations, against any claim by or on behalf of the player named above as a result of the player’s participation in US Club Soccer programs and/or being transported to or from the same, which transportation I hereby authorize. I agree to the Medical Treatment Authorization and Liability Waiver/Release.Privacy Policy & Terms of Use*I acknowledge and agree that I have read, understand and agree to US Club Soccer’s Privacy Policy & Terms of Use (collectively, the “Policy”), available at usclubsoccer.org. The Policy describes US Club Soccer practices for collecting, maintaining, protecting and disclosing player information. In signing below, you agree on your own behalf or on behalf of your child or guardian, as applicable, to the provisions of the Policy and any successor Policy then-in-effect. I agree to the Privacy Policy & Terms of Use.AGREED AND ACCEPTED*I hereby agree and accept all terms and conditions set forth in this Player Information, Medical Treatment Authorization, Liability Waiver/Release, and Consent Form. I agree.NWISC Communicable Disease & Photo Release WaiverCommunicable Disease Waiver*Player and parent/guardian have read and understand the waiver involving the participation in NWISC activities and the possible exposure to illness from infectious and/or communicable diseases including, but not limited to, COVID- 19, MRSA, influenza, and other infectious or communicable diseases. NWISC will be in contact with Iowa Soccer Association, US Club Soccer and other governing bodies to discuss return to play policies and guidelines. NWISC Board of Directors will be in contact with member families on what measures will be taken in regards to social distancing and creating a safe environment during communicable disease pandemics.In the event that the club is non-operational for any reason, the participating families will receive those month(s) of coaching fees credited back onto their account. For example, if teams are unable to meet for two months, the amount of $50 (coaching fee $250/10 months = $25 a month). For any tournament fees that are paid in full in advance and the club teams are unable to attend, that amount will be credited back on the players’ account. NWISC will do the same for the indoor facility rental fee as well. For the months that the club teams are unable to use it in the winter because of pandemic/communicable disease, we will refund that unused fee. I agree to the Communicable Disease Waiver.Photo Release Waiver*I authorize my son’s/daughter’s photograph, picture or likeness, and voice to appear in any documentary, promotion (including adverting), television, video, social media outlets or radio coverage of the league or tournament, without compensation. I agree to the Photo Release Waiver.SignaturesParent/Guardian Signature*Date* MM slash DD slash YYYY Player 1 Signature*Date* MM slash DD slash YYYY This field is hidden when viewing the formPlayer 2 SignaturePlayer 2 Signature*Date* MM slash DD slash YYYY This field is hidden when viewing the formPlayer 3 SignaturePlayer 3 Signature*Date* MM slash DD slash YYYY This field is hidden when viewing the formPlayer 4 SignaturePlayer 4 Signature*Date* MM slash DD slash YYYY This field is hidden when viewing the formImportant NoticeIMPORTANT NOTICE: ALL PLAYERS, PARENTS AND GUARDIANS ARE BOUND BY AND MUST COMPLY WITH ALL US CLUB SOCCER POLICIES AND RULES WHICH CAN BE FOUND ON THE US CLUB SOCCER WEBSITE [usclubsoccer.org].PaymentClub Registration Fees (price per player) Price: Credit Card Convenience Fee ($35.00 per player) $35.00 Pay in Full Discount ($35.00 per player) -$35.00Credit Card Convenience Fee ($35.00 per player) $70.00 Pay in Full Discount ($35.00 per player) -$70.00Credit Card Convenience Fee ($35.00 per player) $140.00 Pay in Full Discount ($35.00 per player) -$140.00Credit Card Convenience Fee ($35.00 per Player)$140.00 Pay in Full Discount ($35.00 per Player)-$140.00Total Payment Method*- Please Select -Credit CardACHCredit Card* EmailThis field is for validation purposes and should be left unchanged.
