CHECKLIST FOR SIGNING DAY - Amazon Web Services Georgia Rush Soccer Club, 14295 Birmingham Highway, Alpharetta, GA 30004 CHECKLIST FOR SIGNING DAY JUNE 6, 2017 SIGNING DAY FOR BIRTH

1 Georgia Rush Soccer Club, 14295 Birmingham Highway, Alpharetta, GA 30004 www.georgiarush.com

CHECKLIST FOR SIGNING DAY

JUNE 6, 2017 SIGNING DAY FOR BIRTH YEARS 2005 THROUGH 2009

JUNE 13, 2017 SIGNING DAY FOR BIRTH YEARS 2004 AND OLDER

TO HELP ALLEVIATE WAITING IN LINE, WE ARE SUGGESTING THE FOLLOWING, IF THIS DOES NOT WORK FOR YOUR SCHEDULE, PLEASE COME WHEN CONVIENENT.

4:00 – 6:00 PM LAST NAMES A-K 6:00 – 8:00 PM LAST NAMES L-Z

______ Signed Medical Release Form (page 2)

______ Signed Player Commitment Form (page 3)

______ Registration and Fee Schedule (page 6)

______ Payment Commitment Form (page 7 & 8) with credit card, postdated checks or ACH completed form (page 9)

______ Copy of Birth Certificate

PLEASE BE AWARE THERE ARE NEW UNIFORMS THIS YEAR. PLEASE VISIT THE UNIFORM AND UNIFORM NUMBER TABLE.

______ Visit New Uniform Table for Sizes

______ Visit Uniform NUMBER table

FORMS IN THIS PACKET CAN BE DIGITALLY COMPLETED & SIGNED


GEORGIA RUSH MEDICAL RELEASE FORM

I,_____________________________ (Parent/Guardian's Name) hereby give permission for any and all medical attention to be

administered to my child ____________________________ (Child's Name) In the event of accident, injury, sickness, etc., under the

direction of the person(s) listed below, until such time as I may be contacted. I also assume the responsibility for the payment of any

such treatment. This release is effective for the period of one year from the date given below.

ADDRESS: _____________________________________________________________

CITY: __________________________________ STATE:____________ ZIP: __________

HOME PHONE: __________________________________________________________

INSURANCE COMP:_______________________________________________________

POLICY NUMBER: _______________________________________________________

In case I cannot be reached, any of the following persons is designated to act on my behalf.

* COACH: __________________________________________________________

* ASST.COACH: _____________________________________________________

* MANAGER: ________________________________________________________

* A league representative where my child is playing.

* Any tournament representative where my child is participating in a tournament

PHYSICIAN: ___________________________________________________________

ADDRESS: _____________________________________________________________

PHONE: _______________________________________________________________

KNOWN ALLERGIES: _____________________________________________________

SIGNATURE (PARENT/GUARDIAN) _______________________________DATE ____________


GEORGIA RUSH PLAYER COMMITMENT TO EXCELLENCE!

CONGRATULATIONS! You have been selected to become a member of GEORGIA RUSH for the 2017/2018 Fall/Spring soccer season. As a member of GEORGIA RUSH, you will play other Academy, Select and R3PL teams in the Metropolitan Atlanta area as well as other teams from other cities in Georgia, participate in area (and perhaps national) tournaments with other competitive teams, and possibly compete for the State of Georgia championship in your age division. You will practice at the finest practice facility in the North Fulton area under the supervision of a group of dedicated coaches and staff.

At this level of competition, the difference between being ordinary and being extra-ordinary is a little extra effort. Success and fun on the soccer field comes with the willingness to not say “I can’t” but instead “I will try my best”. The will to win is not enough; you must also have the will to prepare to win. We are speaking of more than just the effort it takes to show up at the soccer field on the day of the game. We are talking now about the kind of effort that involves some hard work, some choices about the way in which you wish to spend your free time, and perhaps some sacrifices on your part.

Consider carefully the following commitments that each team member must make:

1. I promise to arrange my schedule so that I can come to practice regularly and on time, and to participate in

scheduled games and tournaments.

2. I promise to work hard at practice to improve my soccer skills and my understanding of the game.

3. I promise that, at practice, I will give the coaches my full attention. When the coaches are talking, I will stop

talking, keep my ears open, and my eyes on the coaches. I will not distract others during the practice session.

4. I promise to do whatever is asked of me on the soccer field, without complaining, for the good of the team.

5. I promise always to encourage, and never to criticize, my teammates.

6. I promise always to hustle, and never to quit, until the game is over.

7. I promise to come to each game, on time, well rested, and with an attitude that says -- "It may be difficult, but

believe that we can win."

8. I promise to uphold the 11 Rush Core Values (attached document)

9. I understand that player conduct is observed on an individual basis. Any conduct deemed inappropriate will

be addressed first with a verbal warning. If the misconduct continues, based on Coach determination,

resulting actions could range from individual practice and game penalties to Club suspension.

If you are not willing to make this commitment, then perhaps you should reconsider your decision.

If you are willing to make this commitment, then we believe that we can help you become a better soccer player and a contributing member of a competitive soccer program. As coaches and staff, we commit to you that we also will work hard to help you improve your skills, gain in your knowledge of the game, and make practices a worthwhile experience.

People very seldom are successful at anything unless they can have fun doing it. We will expect you to work hard, but we will make every effort to see to it that you have fun also.

_____________________________ ____________________________ Player Signature Parent Signature

Revised 5/2017


RUSH CORE VALUES

Accountability: Be accountable for your actions and hold others accountable for their actions. Who am I ultimately accountable to, and who judges my work?

Advice: Seek out advice and aspire to be the best. In order to learn, we must be open to learning and consider the advice of others. Are you coach-able?

Empathy: Empathy is at the core of solid relationships.

Enjoyment: Enjoy your work, this is a gift. The desires of diligent workers are satisfied.

Humility: Apologize when you make a mistake. Forgive others and do not look back.

Leadership: Leaders strive to be trustworthy, honest and sincere. They possess traits such as integrity and honor. They are willing to serve others and sacrifice their own interests. Leaders are constructive and hardworking.

Passion: Passion always trusts, always hopes and always perseveres. Passion never fails.

Respect: Respect everyone. Respect the opponent, the rules, your colleagues, your superiors and subordinates. Be thoughtful and considerate.

Safety: Our environment is safe. This includes the office, our travels, the fields and our bodies. Safety is not only physical safety from harm, but safety from ridicule and attack. We are comforted and encouraged in the club. We portray self-control and kindness to our staff, our colleagues and players.

Tenacity: To be successful, persevere.... persevere but do not be anxious. Fear no one. Be strong and courageous. Work when no one is looking, even when the circumstances are not right and everyone else quits. Diligence never loses because it never quits. Out work your opponent, and most importantly, work smart. Don’t wait for external inspiration. The people who go far do so because they motivate themselves and give life their best, regardless of how they feel.

Unity: Together all things are possible. When your teammates are down, bear each other’s burdens; conversely, celebrate your teammate’s successes.


GEORGIA RUSH PARENT CODE OF CONDUCT

OPTIMIZING PARENTAL PERFORMANCE…

Soccer games/practices are as exciting for some parents as they are for their children. They want to support the team, cheer for the team, and encourage their child. Occasionally, this enthusiasm combines with a parent’s lack of familiarity with the game, or lack of knowledge of the coach’s instruction to the team, in a way that causes problems.

We do not wish to curb your enthusiasm for the game. We do wish to make sure that your enthusiasm is channeled in a way that will be helpful, complies with the rules of the game, and is consistent with the coach’s instruction to the team. In this spirit, please keep these suggestions in mind as you attend Georgia Rush games.

LET THE COACHES COACH: This includes goal setting and psyching up your child for practice and post games andpost game critiques. Having more than one “coach” confuses children. When your child is unclear aboutanything a coach is telling them encourage them to talk with their coaches and let them take the responsibilityfor understanding what is being communicated.

ENCOURAGE –DO NOT CRITICIZE: One of our goals is to help your child play good soccer. No less important isour goal to make every effort to ensure that your child has fun. Your child understands the Club’s highexpectations on him or her and feels the peer pressure to do well. You can best help by confining your talkduring the game to positive encouragement. Support your child unconditionally. Do not bribe or offer yourchild incentives for goals of field play. This distracts your child from concentrating properly in practices andgames.

DISPLAY APPROPRIATE “PARENTAL” BEHAVIOR AT PRACTICES AND GAMES: Do not yell your child’s name.Please say, “go team” or “good goal”. Cheering for your child is distracting to them and we want to encourage ateam effort. Support all players on the team – each child has the opportunity to learn from their peers.

KNOW SOMETHING ABOUT THE RULES OF THE GAME: Sometimes, parental ill will toward the referee or aplayer is based upon a parent’s ignorance of the rules of the game. Common problems are the understandingand application of the rules governing off sides and illegal contact. For more information visit the GYSA website,under documents, rules and regulations, you will find the Laws of the Game.

DO NOT YELL AT THE REFEREE: It is our goal to build not only good soccer players, but also good sportsmen.Your positive or negative example at games will either greatly reinforce, or significantly undermine that effort.The coach or team captain has principal responsibility, although limited latitude in speaking with the referee.Let them do their job when and if they feel it is necessary. With respect to tournament play, often onetournament team is given a special award for good sportsmanship. Your yelling and screaming could rob thekids of an opportunity to earn such an award.

KEEP REALITY IN FOCUS: Remind your child to focus on the process, not the result. Some loses are “wins”based on team performance and some wins are “loses: for the same reason.

SUPPORT THE PROGRAM: Get involved by volunteering, for your team and club in any way you can. The moreinvolved you are with your club and team the more your child will know you are supporting their interest

SUPPORT AND UNDERSTAND “The Rush Way” and the 11 Rush Core Values.

Any actions or behavior which is not in keeping with the Georgia Rush Parent Code of Conduct and/or club philosophy should be reported to the Academy/Select Director. The matter will then be directed to the Georgia Rush Disciplinary & Grievance Committee for further action.


2017-2018 Registration & Fee Schedule **Tournament and Uniform fees not included**

Player Name____________________________ Birth Year ___________

All registration and payments must be initiated by the customer online at www.georgiarush.com or in person on signing day. (2005-2009 on June 6, 2017; 2004 and older on June 13, 2017) Every player must have a signed Payment Commitment Form selecting a Payment Plan turned into the club to receive a player card. Payment Commitment Form and deposit or payment in full is due by June 30, 2017.

All Fees Include:

Registration and Administration Fees Coaching fees for team practices and seasonal games (Fall 2017/Spring 2018) Two nights of team training Goalkeeper Training Summer Team Camp (prior to the start of the regular practice season) HS Teams Spring Season Practices Academy – one night of Elite Technical Training Select - one night Speed and Agility training with Peak Performance Spring Friendly season available for 2003s

Once signed with Georgia Rush: I understand that if I take advantage of any of the extended payment plans, it is required to provide post-dated checks, ACH withdrawal form or credit card authorization. All forms of payments will be processed on or within fifteen days of payment due date. If payments are not made on a timely basis, Georgia Rush reserves the right to pull a player’s “player card.” A late fee of $25 may be assessed for any fees not paid by due date. A $25 NSF fee will be assessed for each returned check.

I hereby give approval for the participation of my child in any of the programs held at Georgia Rush Soccer Academy, DBA Georgia Rush Soccer Club. I understand that participation in these programs may involve risk of injury. As a parent, guardian, or participant I am aware of these hazards and my child’s ability to participate.

I agree for myself, my heirs, executors and administrators to waive and release any and all claims of damage; absolve, indemnify and agree to hold harmless; Georgia Rush Soccer Club it successors and assigns, organizers, supervisors, officers, directors, employees, agents and representatives for any and all kinds of injury including but not limited to transportation to and from said activities and personal injury and/or property damage suffered by my child or myself, or my ward, while participating in this activity.

I understand that a player who registers with an affiliated GSSA league is bound to that league for the entire 2017/2018 seasonal year (Both Fall and Spring Seasons). **I further understand that tournament team expenses are the responsibility of every player on the team, regardless of whether or not they are able to attend the team tournament. Uniform expenses are the responsibility of each individual player. I agree that I will pay all tournament and uniform fees.

In addition, I give my permission for my child to be treated by qualified medical personnel in the event that the named parent/guardian cannot be reached at the phone number provided. I also understand and accept that e-mail will be used as the primary form of contact, except in the case of medical emergency. I give permission to use my child’s photo in any club marketing materials.

REFUND POLICY: Georgia Rush Soccer Academy has a no refund policy.*No credit for missing any programs or practices.

____ I have read the above rules and agree.

___________________________________________ Printed Name of Individual Responsible for Payment

_______________________________________

________________________________________ Signature of Individual Responsible for Payment

________________________________________ E-mail address Phone Number

7Georgia Rush Soccer Club, 14295 Birmingham Highway, Alpharetta, GA 30004 www.georgiarush.com

PAYMENT COMMITMENT FORM

Player Name____________________________

Locate your birth year/playing level and place a check mark in the agreed payment plan below.

2006-2009 ACADEMY $400 Registration/Administration Fees and $1,200 Player/Club Fees

______ Option 1: Two payments of $800 each due on June 6 and January 15, 2018

______ Option 2: Deposit of $400 due on June 6 and Five payments of $ 240 due on the 15th of July, August, September, October and November

______Option 3: Pay in full: $1,600, if paid by July 1, 2017 discounted rate of $1,575

2004-2005 SELECT $400 Registration/Administration Fees and $1,200 Player/Club Fees

______ Option 1: Two payments of $800; First payment due on June 6 (2005) or June 13 (2004) and second payment due on January 15, 2018

______ Option 2: Deposit of $400 due on June 6 (2005) or June 13 (2004) and Five payments of $240 due on 15th of July, August, September, October and November

_______Option 3: Pay in full: $1,600, if paid by July 1, 2017 discounted rate of $1,575

2004 R3PL $400 Registration/Administration Fees and $1350 Player/Club Fees

______ Option 1: Two payments $875 due on June 13 and January 15, 2018

______ Option 2: Deposit of $400 due on June 13 and Five payments of $270 due on 15th of July, August, September, October and November

_______Option 3: Pay in full $1,750, if paid by July 1, 2017 discounted rate of $1,725

2003 With SPRING $400 Registration/Administration Fees and $1,000 Player/Club Fees

______ Option 1: Two payments of $700 due on June 13 and September 15

______ Option 2: Deposit of $400 due on June 13 and Four payments of $ 250 due on the 15th of July, August, September, October

______ Option 3: Pay in full $1,400, if paid by July 1, 2017 discounted rate of $1,375

1999-2003 SELECT $400 Registration/Administration Fees and $800 Player/Club Fees

______ Option 1: Two payments of $600 due on June 13 and September 15

______ Option 2: Deposit of $400 due on June 13 and Three payments of $ 266.67 due on the 15th of July, August, and September

______ Option 3: Pay in full $1,200, if paid by July 1, 2017 discounted rate of $1,175


PAYMENT COMMITMENT FORM REQUIRED ***YOU MUST SELECT A FORM OF PAYMENT***

Player Name____________________________

______ CREDIT CARD

Credit Card Number _______________________________________________

Expiration Date___________________________________________________

3 or 4 Digit Security code___________________________________________

Zip Code for card payment__________________________________________

Name Printed on Credit Card ________________________________________

Billing address for this Credit Card you are using:

Street Address ___________________________________________________

City ____________________________________________________________

We accept Visa, Mastercard and American Express and other major credit cards.

Payments made by credit card will incur a convenience fee of 3.4%

______ ACH Debit Authorization Form. The form is completed and voided check attached.

______ I have attached POST DATED checks made payable to: Georgia Rush

__________________________________________________________________________

Signature of Individual Responsible for Payment Date

_________________________________________________________________________

Printed Name of Individual Responsible for Payment Phone Number

***It is the customer’s responsibility to report to Georgia Rush any problems with credit cards, such as lost or stolen cards, updated credit card expiration dates, and problems with banking accounts associated with post-dated checks. Thank you!



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?

Signs and symptoms of concussi on can show up right

after the injury or may not appear or be noticed unti l

days or weeks after the injury.

I f an athlete repor ts one or more symptoms of

concussion listed below after a bump, blow, or jolt to

the head or body, s/he should be kept 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 retur n to play.

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 l ikely to

get a concussion and take longer to recover

than adults.

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 br iefly) 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”


Documents

CHECKLIST FOR SIGNING DAY - Amazon Web Services Georgia Rush Soccer Club, 14295 Birmingham Highway, Alpharetta, GA 30004 CHECKLIST FOR SIGNING DAY JUNE 6, 2017 SIGNING DAY FOR BIRTH