Us Soccer Medical Insurance Form Pdf

The insurance information on this website is a summary of the policy benefits terms and conditions and does not alter broaden or limit.

Us soccer medical insurance form pdf. Summaries of coverage are below and linked within this web page. Has of the participant s medical condition is contained in the information that i have provided on this form. Membership form updated 6 27 19 asa head injury concussion policy procedures. Us youth soccer association bylaws.

Please copy both sides of your health insurance card and attach to this form parent guardian consent and medical release recognizing the possibility of injury or illness and in consideration for us youth soccer and members of us youth soccer accepting my son daughter as a player in the soccer programs and activities of us youth soccer. Excess accident medical policy typical coverage includes. This soccer registration form template is an easy way for online registration. Iysa forms policies.

Illinois youth soccer concussion notification form. This form is required and registrars may certify they are in possession of it when registering with us club soccer. Us youth soccer policy on players regarding rules. As a benefit to membership us club soccer provides accident and liability insurance coverage to members while participating in us club soccer operated and sanctioned covered activities.

Iysa medical release liability waiver updated 2 20 2020 illinois youth soccer policies procedures updated 7 13 2019 organization statement of understanding updated 6 1 2019 risk management forms illinois youth soccer risk management precautions. Pullen insurance services is proud to be the insurance provider of choice for us youth soccer and many of its member state soccer associations. Coverage of medical expenses for injuries doctors office visits hospitalization therapy etc. This soccer registration form allows child information parent information uniform information such as the size of the shirt and size of the short medical information.

To help create a safe environment for all players the da has implemented safety standards including the presence of a medically certified trainer at every game the recognize to recover program and safety guidelines all clubs are required to follow. Asa staff parent player code of conduct updated 6 27 19 asa staff parent player code of conduct espanol. I acknowledge that the only knowledge southwest missouri sports camps inc. Information will be provided to a healthcare provider in order to allow said provider to render medical treatment to the participant.

On this site member affiliates can view coverage outlines accident medical claims forms and view optional coverage available for member association leagues and clubs. Are covered necessary medications medical appliances required for treatment coverage becomes primary when other insurance coverage is not available. This form must be retained for at least five 5 years or until the player s 18th birthday whichever occurs last.