Mass Youth Soccer Member Organization COVID-19 Safety Officer Enrollment Form

Based on strong recommendations from the Commonwealth of Massachusetts, U.S. Soccer, US Youth Soccer and other governing entities, Mass Youth Soccer requires all Member Organizations to appoint an individual(s) to act as their COVID-19 Safety Officer(s). The COVID-19 Safety Officer(s) will be responsible for communicating policies organization-wide, to coaching staff, administrators, parents, and players.

This person(s) can be the current organization's CORI Submitter/Risk Manager or another person(s) appointed by the member organization's board.

Below is an agreement for each appointed COVID-19 Safety Officer to complete and submit to Mass Youth Soccer.

Massachusetts Youth Soccer COVID-19 Safety Officer Agreement

Participants, parents, family and spectators taking part in soccer and soccer related activities do so with the knowledge of risk and potential exposure involved. In doing so they agree to accept any and all inherent risks to their personal health. However, it is the responsibility of Massachusetts Youth Soccer and its member organization to ensure all guidelines provided by the Center for Disease Control, Commonwealth of Massachusetts, and local public health authorities are being implemented and followed to protect all members of our soccer community.

I acknowledge that I have read and understand the Massachusetts Youth Soccer Return to Soccer Activities Guidelines and associated documents. I acknowledge that I, or another board member, have contacted the local public health department to review their guidelines and recommendations. I will work together with all members of my Member Organization to ensure that the guidelines and procedures as provided by Massachusetts Youth Soccer and my local health department are adhered to and implemented prior to, during, and after all soccer activities conducted by our organization.

Member Organization (No abbreviations) *

First Name *

Last Name *

Email Address *

Phone Number (e.g. xxxxxxxxxx, 10 #'s no hyphens or parenthesis) *

Current Board Position (If not on board enter None) *

Electronic Signature (Use mouse/pointer to sign) *

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