UTAH DEVELOPMENT ACADEMY Strengthening communities through soccer

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1 UTAH DEVELOPMENT ACADEMY Strengthening communities through soccer Read Financial Policy and Complete 2018 Financial Commitment Form / Lea la policía de financiero y llenar el documento de compromiso financiero de jugador Photocopy Proof of Reduced Fee Qualification (if applicable) Prueba de almuerzo gratis o reducido (si esta aplicable) Complete UYSA Participant Registration Form (skip this step if registered online) Llenar el documento de registración de UYSA (Pasa al próximo si ya registró) Read and sign UDA Photo Release Waiver Lea y firme el documento de permisión por fotos Photocopy Birth Certificate (NEW players only) Copia de Acta de Nacimiento (nuevos jugadores) Take Player Photo (REQUIRED for all players) Toma foto del jugador (Mandatorio por todos) *Uniform Ordering NEW players will receive an from SOCCER.COM Customer Service (custserv@sportsendeavors.com). More information can be found at / Nuevos jugadores van a recibir un correo electrónico de SOCCER.COM Customer Service (custserv@sportsendeavors.com). Hay más información en Contact Information Executive Director: Office Manager: Office Hours: Mailing Address: Website: Facebook: Twitter: TYLER STOCKSTILL tyler.stockstill@udasoccer.org MAGDALY RUIZ (habla español) admin@udasoccer.org (385) M F from 2:00pm 8:00pm UTAH DEVELOPMENT ACADEMY 75 S 600 W Salt Lake City, UT Utah Development Academy UDA Soccer

2 Cost of Participation Utah Youth Soccer Association Fees Paid through Affinity Sports to Utah Youth Soccer Association at the time of registration Membership Fee $11 PL, SCL, IRL, and X-League Fee $30-$50 Legacy Field Project Fee $40 What is included in Utah Development Academy Competition Fees? Program service Facility rentals (includes WINTER FUTSAL801) Field and training equipment UYSA Referee fees Employee salaries and wages NO ADDITIONAL MONTHLY TRAINERS FEES! Coaches education and training Office expenses Insurance Additional costs throughout the year: Uniform Package $120 (required on odd years and required for NEW players only) Optional uniform items include backpacks, warm-up jackets and pants Tournament fees and travel $50-$100 *May hold team fundraisers to cover additional costs. Age Group Annual Player Fee Annual Player Fee (with Fee Waiver applied) Under 9 - Under 10 $ $ Under 11 - Under 15 $1, $ Under 16 Under 19 $1, $ Club Fundraising Club fundraising helps UDA reduce the Annual Player Fee to ensure that competition soccer is affordable and accessible for all children. Each family should plan to participate in a minimum of one (1) club fundraiser throughout the year. Financial Aid - Types Fee Waiver UDA provides fee waivers for all players that meet INCOME ELIGIBILITY GUIDELINES used in determining eligibility for free and reduced price school meals. Parents/guardians should provide a copy of their application approval letter to qualify at the time of registration. Work-2-Play UDA provides work opportunities for players with financial need, allowing them to deduct program expenses for high school students (2004 and older). Family Discount UDA provides a Family Discount when there are multiple siblings simultaneously participating. In such an instance, the older of the siblings receives a 10% reduction of fees. If there is a third sibling enrolled, a 20% reduction is provided to the older sibling and 10% reduction to the middle sibling. Families with multiple siblings may be eligible for extended payment plans without charge. Financial Hardship Hardships are financial situations and other circumstances that keep you from meeting the financial commitment. If you will not be able make a payment before the due date or you need to extend your payment plan, please contact admin@udasoccer.org.

3 Payment Plans To meet the diverse financial needs of our players and families, payment plans allow you to divide your balance due into multiple installment payments instead of paying in one lump sum. Option A: PAY IN FULL Balance is due by June 30th Option B: 50/50 Plan Balance is divided into 2 equal payments. First payment is due on or before July 18th; the second payment is due on or before August 18th. $20 administrative fee, no interest! Option C: 5-Month Plan FOR FAMILIES WITH MULTIPLE PLAYERS ONLY Balance is divided into 5 equal payments. Payments due on or before the 18th of each month; beginning July 18th and ending November 18th. How to Pay After Registration Day, you will receive an electronic invoice from quickbooks@notification.intuit.com (please be sure to check your spam filters) with your balance and payment plan you selected. It is your responsibility to make payments on or before the payment due date; Failure to make on-time payments will result in a bad standing designation restricting my player from participating in games until good standing is returned. Payments can be made: AT FUTSAL801: Payments may be mailed (Checks ONLY) or dropped off in a labeled envelope in the secure dropbox outside FUTSAL801 (75 S 600 W, Salt Lake City, UT 84101) or made in person during office hours. BANK TRANSFER (E-check): Once your electronic invoice arrives, you can submit a payment by entering your account information and the amount you would like to pay. Follow the links in the invoice for additional instruction. CREDIT CARD: If you would like to pay by Credit card, please request by replying to the containing your invoice (the surcharge will be added to your invoice 3.4% + 25 ). If you have any questions or concerns about your invoice, please contact us via or phone. Refund Policy When a team is formed and players register for the team, they are making a commitment that is expected to last for the entire club year. If after the team is formed a player withdraws, it places the remaining players at a disadvantage. In some cases, the team may fall short of the required number of players to remain registered with the league. Players and families are expected to give serious consideration to this commitment when they register and commit to a team. If a player leaves the team for any reason, excluding a severe injury or family move, they are expected to honor the FULL financial commitment (even if they had previously qualified for Fee Reduction).

4 Financial Commitment Form As a participant of Utah Development Academy for the season, I agree to the following terms: 1. My player will attend games, practices, and club training sessions. If my son/daughter cannot be in attendance, I will notify the Coach and/or Team Admin in advance to explain the reason for the absence. 2. My player will be committed to their Utah Development Academy team for the entire seasonal year (June - May). Transfer requests to another club will require the full payment of the entire Annual Player Fee. 3. I will help with team administrative duties and/or support functions (i.e., field set up/take down, fundraisers, etc.). Please read through the following options and complete: Do you qualify for free or reduced lunch? (circle one) Yes No Payment Plan (circle one) FULL 50/50 5-Month (Multi-child only) Preferred Payment Method (circle one) CASH/CHECK Bank transfer/e-check (NO FEE) Credit Card (3.4% + $0.25 fee) With my signature, I agree to all the terms above. Failure to make on-time payments will result in a bad standing designation restricting my player from participating in games until good standing is returned. Player s Name (printed): Birth Year: Parent Name (printed): Parent Signature: Parent *: *You will receive an electronic invoice from quickbooks@notification.intuit.com (please be sure to check your spam filters) with your balance and payment plan you selected.

5 Utah Youth Soccer Association Participant Registration Form PLEASE PRINT FIRMLY AND LEGIBLY TO MAKE CLEAR MULTIPLE COPIES. PARENT/ GUARDIAN INFORMATION Name of the Parent/Guardian 1 Relationship to Child Mailing Address City Zip Player Physical Address City Zip Home Phone ( ) Work Phone (_ )_ Cell Phone ( ) Gender Name of the Parent/Guardian 2 Relationship to Child Home Phone ( ) Work Phone (_ ) Cell Phone ( ) Gender PLAYER INFORMATION Player s Name (First/ MI /Last) Gender DOB (MM/DD/YYYY) /_ / Elementary School Grade Shirt Size Short Size Sock Size Emergency Contact (Other than Parent) Telephone(_ )_ Doctor to Notify in an Emergency Telephone( ) List Medical Problem/Prohibition Player Has I WOULD LIKE TO HELP BY VOLUNTEERING Coach Assistant Coach Team Manager Team Parent Special Project Fund Raising Field Preparation Referee CONSENT FOR MEDICAL TREATMENT As parent or legal guardian of the above-named registrant, I hereby give my consent for emergency medical care prescribed by a duly licensed Doctor of Medicine or Doctor of Dentistry. This care may be given under whatever conditions are deemed necessary to preserve the life, limb, or well-being of the registrant. PARENT/GUARDIAN SIGNATURE _DATE_ PARTICIPATION RISK STATEMENT I, the undersigned am a parent or legal guardian of the named minor. I fully understand that participating in the sport of soccer presents a risk for serious injury and death. In my capacity as parent or legal guardian, I understand the risks and my responsibility to notify the other parent or legal guardians as well as the minor of the risks involved with sport participation. I have made a conscious decision to allow the named minor to play. I agree that my health and accident insurance will be the primary insurance to cover expenses for any such injury, including rehabilitation. PARENT/GUARDIAN SIGNATURE _DATE_ ADMINISTRATIVE USE ONLY Competition Recreation League / Club Name District Number League/Club Number Team Number Age-Group Birth Certificate Verified New Player Returning Player If Returning Player, UYSA ID Number Registration Fees: $ Received by: Total: $ Date Received: CASH or CHECK # THE GOVERNING BODY FOR AMATEUR YOUTH SOCCER IN UTAH Utah Youth Soccer is the only Utah provider of youth soccer approved by both the United States Youth Soccer Association (USYSA) and the United States Soccer Federation (USSF)

6 UTAH DEVELOPMENT ACADEMY Photo Release Waiver I hereby permit and authorize the Utah Development Academy (UDA) and its agents, sponsors and others acting on its behalf, to use, reproduce and/or publish photographs and/or video that may pertain to the registered child/children, including their image, likeness and/or voice, without compensation. I understand that this material may be used in various publications, public relations or marketing releases, recruiting materials or for other endeavors specifically related to promotion of the sport of soccer. This material may also appear on UDA s website or Facebook page. Consequently, UDA may publish materials, use my child s/children s name, photograph and/or make reference to my child/children in any manner that the Association deems appropriate in order to promote or publicize itself and its endeavors in relation to growing the sport of soccer in the city of Salt Lake and surrounding areas. I have read and agree to the UDA Photo Release Waiver. Player s Name Birth Year Parent/Guardian Signature Date