Please complete the following to accept your academy offer  


Player Name *
Player Name
Phone *
Cell: *
Date of Birth *
Date of Birth
Passport Expiration Date
Passport Expiration Date
Please SELECT yes or no
Please SELECT proper age group
Please SELECT proper size
Please SELECT primary position
1st Parent Name *
1st Parent Name
Phone *
2nd Parent Name *
2nd Parent Name
Phone *
The city determines the academy practice field allocation priority based on percentage of residency. We must provide utility number and last name on the utility as a mechanism of confirming residency. If you are not a Palo Alto or Redwood City Resident, put "n/a" in both fields for Utility # and Utility Last Name.
Players Under 18 Must Have Parents Provide Electronic Signature
Acceptance of Offer and Agreement of Fees *
By submitting this academy offer acceptance, I commit to the Silicon Valley Soccer Academy program for the U12, U13, U14, U15, U17 and/or U19 team that I am placed on as my sole competitive team for the duration of the upcoming/current season. My commitment is for the 2018-2019 seasonal year of play in the US Soccer Development Academy league as well as any showcases and playoffs as it applies to my birth year. I understand a spot on the team is being held resulting in another player being denied an opportunity. I agree to pay the deposit and any other fees required by the due dates to continue to hold the place on the team. I also understand that the fees are non-refundable and SVSA has no obligation to release a player's registration to play for another USSDA academy.
Academy Waiver *
I, the Player, or parent/guardian of the minor Player, acknowledge that soccer is an inherently dangerous sport in which the Player participates at his/her own risk. I, for myself and the Player and our respective heirs, administrators and successors, intending to be legally bound, hereby release and indemnify the (1) US Soccer, its affiliated organizations and its sponsors, (2) Silicon Valley Soccer Academy, its officers, directors, coaches, team managers, volunteers, agents, representatives and assigns, (3) the City of Palo Alto and Redwood City and all other organizations providing fields for play, including their agents, officers, directors, contractors, employees, representatives and assigns (collectively “Released Parties”), from and against all claims, liabilities, damages or causes of action arising out of or in connection with the Player’s participation in any and all Silicon Valley Soccer Academy programs. I affirm that the Player is in good physical condition. I understand that the Silicon Valley Soccer Academy does not carry medical insurance for Players participating in tryouts, practices, friendly scrimmages and other Silicon Valley Soccer Academy sponsored activities, and that I am responsible for the Player’s insurance coverage until the Player is officially registered as a Player with US Soccer.
Consent for Medical Care *
As the parent or legal guardian of the above-named Player, I hereby give 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 necessary to preserve the life, limb or well-being of my dependent.
Photo/Video Consent *
I hereby authorize Silicon Valley Soccer Academy (SVSA) permission to use my likeness in a photograph in any and all of its publications, including but not limited to all Silicon Valley Soccer Academy (SVSA)'s printed and digital publications. I understand and agree that any photograph using my likeness will become property of SVSA and will not be returned. I acknowledge that since my participation with SVSA is voluntary, I will receive no financial compensation. I hereby irrevocably authorize SVSA to edit, alter, copy, exhibit, publish or distribute photos or video for the purpose of publicizing SVSA's programs or for any other related, lawful purpose. In addition, I waive the right to inspect or approve the finished product, including written or electronic copy, wherein my likeness appears. Additionally, I waive any right to royalties or other compensation arising or related to the use of the photographs or video used. I hereby hold harmless and release and forever discharge SVSA from all claims, demands, and causes of action which I, my heirs, representatives, executors, administrators, or any other persons acting on my behalf or on behalf of my state have or may have by reason of this authorization.
Sideline Code of Conduct *
The following is a summary of Silicon Valley Soccer Academy's Sideline Code of Conduct: - Remember children are involved in organized sports for their enjoyment, not yours. Do not force an unwilling child to participate. - Teach your player that hard work and an honest effort are often more important than a victory. - Help your player work towards skill improvement and good sportsmanship – even in defeat your child will be a winner. - Be a positive role model whenever you are around players. Set a good example – do not yell at, ridicule, or criticize your child or any other player. Instead applaud good plays by your team and by those of the opposing team. - Support all efforts to remove verbal and physical abuse from youth sporting activities. - Show respect to all coaches, referees, and academy officials. We will support a zero tolerance policy as to questioning and harassment of referees. Leave conflict resolution to the referee coordinator, technical directors or academy directors when appropriate. - Remain on the parent side of the field (not near the goals or player's side). Avoid coaching from the sidelines as it can be in conflict with the coach's instructions.
Required Documents (must be current) *
Electronic Signature *
Electronic Signature
Date *