East West All-Star Womens Soccer Acceptance | North Carolina Coaches Association: Online Forms

INVITATION

Who will you be playing for?*

East
West

Name*

First Last

Email*

Invitation*

I accept this invitation
I decline this invitation
Dropped

PLAYER INFORMATION

Address*

Street Address City State ZIP Code

Will you live in the above address during the months of May-June-July?

Yes
No

Address*

Street Address City State ZIP Code

Home Phone (including area code)*

Cell Phone (including area code)*

Parent-Guardian's Name*

First Last

Parent's Email*

Parent's Cell Phone*

Parent-Guardian's Name 2

First Last

Parent's Email 2

Parent's Cell Phone 2

Name of High School*

Age*

Weight*

Height*

Shoe Size (needed for game socks)*

T-Shirt Size*

Game Jersey Size*

Game Pants Size*

Summer Plans*

I will not be attending summer school and will be in Greensboro for the entire 3-day period - July 16, 17 and 18.
I will be attending summer school but will be released for the entire 3 days of East-West All-Star activities.
I will be involved in State/Regional/National competition but will be released for the entire 3 days of East-West All-Star activities.

Name of College or University Attending For Summer School*

Name of competition*

Start Date for Competition*

End Date for Competition*

PLAYER INFORMATION FOR PRESS RELEASES AND GAME PROGRAM

What position will you play in this All-Star sport ?*

Stats

Stats and honors in All-Star sport for each year of high school and any All-Conference and/or All-State recognitions. Limit your list to the achievements and recognitions that are the most meaningful to you. Do not attach extra pages.
(FB = TDs, rushing/passing yards, tackles, etc; BK = points/rebounds per game, etc; SOC = goals, assists, goalie stats, etc.)

Senior Year*

Max 500 characters

Junior Year

Max 250 characters

Sophomore Year

Max 250 characters

Other sports played/records, awards:

Max 250 characters

Other high school activities and honors (academic awards, clubs, offices held, etc.)

Max 350 characters

Do you plan to enroll in college this Fall?*

What college?*

I will be playing*

What major do you plan?*

What are your career plans?*

Max 350 characters

Do you have a role model (not an athlete)?*

Who is your role model?*

Who is your favorite college athlete?*

Who is your favorite professional athlete?*

How do you feel about playing in the All-Star game? What are you expecting to gain from participating?*

Max 600 characters

PLAYER COLOR PHOTO

Please upload or email a quality photo of at least 200 KB (preferably like a yearbook formal) to eastwestprogram@gmail.com.

Attach a head and shoulders yearbook-quality digital photo (jpg.) of at least 200 dpi

If a photo is not is available at this time, please email a comparable digital photo to eastwestprogram@gmail.com OR mail a comparable photo to:

Mary Buchanan, NCCA,
1101 Westover Terrace
Greensboro, NC, 27408

Photos marked as "proofs" or images printed out on plain paper are not acceptable.

Max. file size: 12 MB.

Attach an action shot digital photo (jpg.) of at least 200 dpi

If a photo is not is available at this time, please email a comparable digital photo to eastwestprogram@gmail.com OR mail a comparable photo to:

Mary Buchanan, NCCA,
1101 Westover Terrace
Greensboro, NC, 27408

Photos marked as "proofs" or images printed out on plain paper are not acceptable.

Max. file size: 12 MB.

COACH INFORMATION

Name*

First Last

Email*

Mailing Address*

Street Address City State ZIP Code

Home Phone (including area code)*

School Phone (including area code)*

Cell Phone (including area code)*

Fax (including area code)

Preferred form of communication?*

Text
Email

STUDENT ATHLETE AND PARENTAL AGREEMENT TO PARTICIPATE

Agreement to Participate*

We are aware that playing in interscholastic sports can be a dangerous activity involving many risks of injury. We understand the dangers and risks of playing or practicing in these activities includes death, serious neck and spinal injuries which may result in complete or partial paralysis or brain damage, serious injury to virtually all bones, joints, ligaments, muscles, tendons, and other aspects of the student athlete’s body, general health and well-being.

     Because of the dangers of participating in these activities, the student athlete recognizes the importance of following the coaches’ instructions regarding playing techniques, training, rules of the sport, other team rules and obeying such instructions. We also understand that in order to maintain his or her eligibility to participate in the East-West All-Star Games, he or she must abide by these instructions as well as all applicable team rules.

     In consideration of the North Carolina Coaches Association permitting the undersigned student athlete to practice for and play in the East-West All-Star Games, and to engage in all activities related to the team, including practicing, playing, and travel, we hereby voluntarily assume all risks associated with participation and agree to exonerate and save harmless the North Carolina Coaches Association, their agents, servants and employees from any and all liability, claims, causes of action or demands of any kind and nature whatsoever which may arise by or in connection with his or her participation in any activities related to the East-West All-Star Games.

     By this Agreement to Participate, the athlete listed above acquits and releases the North Carolina Coaches Association from liability for personal injury, property damage or wrongful death arising out of such participation in the East-West All-Star Games.

     By playing in a NCCA all-star game the participant grants the NCCA full license to use the player’s name, image and likeness for a period of thirteen months.

PLAYER, PARENT AND COACH CONFIRMATIONS BY SIGNATURE

By my signature below, I agree that participation in the East-West All-Star Games requires that an athlete be responsible for his/her conduct at all times and that sportsmanship be promoted among the athletes and coaches competing. I understand that players who do not promote this attitude will be dismissed from the games. I understand All-Star Soccer activities are July 16 - July 18, 2023.

Date*

Player Signature*

Coach Attestation*

I verify that the athlete mentioned above is 18 years of age or older OR has cleared his participation in all activities with a parent.

Coach Signature*