CALIFORNIA YOUTH SOCCER ASSOCIATION
CHECK IN FORM FOR TEAMS
PLAYING IN CAL NORTH TOURNAMENTS
NAME OF TOURNAMENT
DATE OF TOURNAMENT
TEAM NAME: ________________________________________ CONTACT NAME
CELL PHONE: ________________________________________ HOTEL NAME (OPTIONAL)
CREDENTIALS FOR THIS TEAM ISSUED BY (LIST NAME OF STATE ASSN OR OTHER ORGANIZATION)
IF A CAL NORTH TEAM INDICATE DISTRICT #: ___ LEAGUE #: ___CLUB #: ___TEAM #: ___GENDER:
BOYS
GIRLS
MIXED
AGE DIVISION:_________
U9 Oldest 08/01/2003
U13 Oldest 08/01/1999
U17 Oldest 08/01/1995
U10 Oldest 08/01/2002
U14 Oldest 08/01/1998
U18 Oldest 08/01/1994
ADULTS:
TOTAL number of Adults __________
U11 Oldest 08/01/2001
U15 Oldest 08/01/1997
U19 Oldest 08/01/1993
U12 Oldest 08/01/2000
U16 Oldest 08/01/1996
PLAYERS:
Number of Players listed on Official Roster__________
Number of Guest Players (1611)
(+) __________
TOTAL
(=) __________
SEASONAL YEAR OF MEMBER PASSES:
TOTAL number of Adult Member Passes
TOTAL number of Player Member Passes
THE TOTAL NUMBER OF PLAYERS ON THE TEAM ROSTER PLUS THE NUMBER OF GUEST PLAYER FORMS CAN TOTAL NO
MORE THAN 18 FOR U-13 AND YOUNGER TEAMS OR 22 FOR U-14 AND OLDER TEAMS. TOURNAMENT OFFICIALS MUST
RETAIN THE PLAYER PASSES IN EXCESS OF THE ALLOWABLE ROSTER MAXIMUMS FOR THOSE PLAYERS WHO ARE NOT
PARTICIPATING. GUEST PLAYERS ARE USED ONLY TO SUPPLEMENT A ROSTER TO A MAXIMUM OF 18 PLAYERS (OR 22
PLAYERS ON U14 – U19 TEAMS). A TEAM MAY NEVER USE MORE GUEST PLAYERS THAN THE TOURNAMENT RULES PERMIT,
NEVER TO EXCEED SEVEN (7) GUEST PLAYERS. SEE BACK OF FORM FOR DETAILED INSTRUCTIONS REGARDING THE USE
OF GUEST PLAYER CREDENTIALS.
CHECK ROSTER FOR PLAYERS’ ELIGIBLE DATE FOR PARTICIPATION FOR EACH ADDED AND TRANSFERRED PLAYER.
RETAIN PLAYER PASS FOR ANY PLAYER NOT ELIGIBLE BY TOURNAMENT START DATE. RETURN THE PASS AT THE
CONCLUSION OF THE TOURNAMENT.
CHECK APPROVED MEMBER PASSES (ALL PASSES FOR A TEAM, INCLUDING GUEST PLAYERS MUST BE FROM THE SAME
SEASONAL YEAR AND FROM THE SAME ORGANIZATION):
ALL PASSES ARE AUTHORIZED BY THE TEAM’S SANCTIONING BODY? YES ___NO ___ (RETAIN ANY UNAUTHORIZED PASS)
MEDICAL RELEASE FORMS SIGNED? YES ___ NO ___ (RETAIN THE PASS FOR ANY UNSIGNED MEDICAL RELEASE FORM)
DOES ANY REGISTERED TEAM OFFICIAL, PLAYER OR GUEST PLAYER HAVE A SUSPENSION TO BE SERVED? (RETAIN PASS
FOR ANY INDIVIDUAL WITH A SUSPENSION TO BE SERVED. A GUEST PLAYER MAY NOT SERVE A SUPSENSION FROM A
SUSPENSION EARNED WITH ANY OTHER TEAM.
LIST NAME FOR ANY MEMBER PASSES RETAINED AND REASON WITHHELD (I.E. MISSING OR INCOMPLETE MEDICAL /
LIABILITY RELEASE FORM, TOTAL OF ROSTERED PLAYERS PLUS GUEST PLAYERS EXCEEDS 18( OR EXCEEDS 22 ON U14-U19
TEAM ROSTERS), RED CARD TO BE SERVED, OTHER PROBLEM)
1
6
2
7
3
8
4
9
5
10
OTHER PROBLEMS: __________________________________________________________________________________________
COACH/MANAGER SIGNATURE
Cal North Form 2615 Rev 5/12
TOURNAMENT OFFICIAL SIGNATURE
DATE
CREDENTIAL PROCEDURES FOR DIRECTORS OF CAL NORTH
TOURNAMENTS APPROVED TO INCLUDE GUEST PLAYERS
1.
ONLY TOURNAMENTS THAT HAVE BEEN APPROVED FOR GUEST PLAYER STATUS
MAY PERMIT THE USE OF GUEST PLAYERS.
2.
A TOURNAMENT SHALL PERMIT ANY TEAM TO USE ONLY THE NUMBER OF GUEST
PLAYERS THAT ARE SPECIFIED IN THE TOURNAMENT’S APPROVED RULES. (CAL
NORTH PERMITS UP TO SEVEN GUEST PLAYERS, BUT IF TOURNAMENT RULES
SPECIFY FEWER THAN SEVEN GUEST PLAYERS ARE ALLOWED, THE
TOURNAMENT RULES SHALL PREVAIL.
3.
THE TOURNAMENT DIRECTOR OR DESIGNEE WILL REVIEW ALL INFORMATION ON
THE APPROVED GUEST PLAYER FORM AT THE TIME OF THE TEAM CHECK IN.
4.
THERE SHALL BE A CORRESPONDING CAL NORTH GUEST PLAYER APPROVAL
FORM, 1601 AND MEMBERPASS FOR EVERY GUEST PLAYER PARTICIPATING IN
THE TOURNAMENT
5.
AT NO TIME WILL A TEAM BE ALLOWED TO HOLD MORE THAN 18 PLAYER PASSES
FOR AN U-15 AND YOUNGER TEAM OR 22 FOR AN U-16 AND OLDER TEAM DURING
A TOURNAMENT.
6.
IN THE INSTANCE WHERE THE TOTAL NUMBER OF PLAYERS ON THE TEAM
ROSTER PLUS THE NUMBER OF GUEST PLAYERS EXCEEDS 18 PLAYERSON AN U15 OR YOUNGER TEAM OR 22 PLAYERS ON A U16 OR OLDER TEAM, THE
TEAMWILL BE REQUIRED TO TURN IN A MEMBER PASSES FOR EACH OF THE
ROSTERED PLAYERS WHO IS BEING REPLACED BY A GUEST PLAYER IN ORDER
TO BRING THE TOTAL NUMBER OF PLAYER PASSES BEING HELD BY ANY GIVEN
TEAM TO 18 OR 22. FAILURE TO TURN IN A MEMBERPASS FOR THE PLAYER WHO
IS BEING REPLACED BY THE GUEST PLAYER WILL DISQUALIFY THAT GUEST
PLAYER.
7.
IF THE TOTAL NUMBER OF ROSTERED PLAYERS PLUS THE NUMBER OF GUEST
PLAYERS FOR A GIVEN TEAM DOES NOT EXCEED 18 FOR AN U-15 OR YOUNGER
TEAM OR 22 FOR AN U-16 AND OLDER TEAM, THE TEAM IS NOT REQUIRED TO
TURN IN ANY PASSES TO THE TOURNAMENT DIRECTOR.
8.
A TEAM MAY NOT USE A GUEST PLAYER REPLACEMENT FOR ANY PLAYER WHO IS
SERVING A SEND OFF (RED CARD) PENALTY
9.
A PLAYER MAY NOT SERVE A SUSPENSION EARNED WITH HIS/HER TEAM BY
PARTICIPATING AS A GUEST PLAYER WITH ANOTHER TEAM.
10.
WHEN TOTALING THE NUMBER OF ROSTERED PLAYERS AND GUEST PLAYERS
FOR TEAMS WITH AN EXCESS OF 18 PLAYERS ON U-15 AND YOUNGER TEAMS OR
22 PLAYERS ON U-16 AND OLDER TEAMS, THE TOURNAMENT DIRECTOR WILL
RETAIN THE MEMBER PASSES IN EXCESS OF 18 OR 22 TOTAL PLAYERS UNTIL
THE END OF THE LAST GAME PLAYED BY THAT TEAM IN THE TOURNAMENT.
CALIFORNIA YOUTH SOCCER ASSOCIATION
REFEREE’S SEND-OFF REPORT
Game Date: ________________________ Field: __________________________City:
Name of League or Tournament::
Game Time:
Home Team:
Visiting Team:
Name of Individual:_______________________________________ Team:
Age Group:
Registration #
Individual Sent Off Was:
Jersey #
Player
Coach
Time of Foul:
(Section 4:08:06, 2 additional games for coach)
REASON FOR SEND OFF:
SERIOUS FOUL PLAY (4:05:02 A-1, 1 game minimum or 4:05:02 A-2, 2 game minimum)
DENIED OBVIOUS GOAL-SCORING OPPORTUNITY BY DELIBERATELY HANDLING BALL OR BY
INTENTIONALLY IMPEDING OPPONENT (Section 4:05:02 A-1, 1 game minimum)
DENIED OBVIOUS GOAL-SCORINGOPPORTUNITY TO OPPONENT MOVINGTOWARDS GOAL BY OFFENSE
PUNISHABLE WITH FREE KICK OR PENALTY KICK (Section 4:05:02 A-2, 2 game minimum)
VIOLENT CONDUCT (Section 4:05:02 D, 2 game minimum)
SPIT AT OPPONENT OR ANY OTHER PERSON (Section 4:05:02 D, 2 game minimum)
OFFENSIVE, INSULTING OR ABUSIVE LANGUAGE (Section 4:05:02 B, 1 game minimum if uttered in frustration
but not directed at a person; 2 game minimum if directed toward any person)
SPECIFIC LANGUAGE OR GESTURE:____________________________________________
DIRECTED AT:
OPPONENT
TEAMMATE
REFEREE
COACH
SELF
OTHER:___________________
RECEIVED SECOND CAUTION IN SAME GAME (Section 4:05:02 C, 1 game minimum)
REFEREE’S EXPLANATION OF SITUATION:
(use back for more space)
Referee:__________
____________________________ Phone: ___________
___ E-Mail: ______________
AR 1: ____________________________
___________ Phone: __________________ E-Mail: ______________
AR 2: ____________________________
___________ Phone: __________________ E-Mail: ______________
DISCIPLINARY COMMITTEE ACTION
Section 4:08:06 requires that coaches and assistant coaches sent off shall have two games added to the suspension that would be levied against a player.
Number of Games Suspended: _______Number of Games Served: _______ on
Send Off Report sent to:
(name)
(indicate date & time of games served)
on _______ Pass returned to:
_________________________________________________
Official Assessing Penalty
Position
Cal North Form 2301 Revised 5/12
(date)
(who pass sent or given to)
_______________________________________
Date
on ______
(date)
________________
CALIFORNIA YOUTH SOCCER ASSOCIATION
REFEREE’S SEND-OFF REPORT
EXPLANATION CONTINUED:
CAL NORTH TOURNAMENT INFRACTION AND RECONCILIATION REPORT
TOURNAMENT INFORMATION
Tournament Name: ____________________________________________ District: __________________
Tournament Dates: ________________________________________Tournament #: __________________
Tournament Director: _____________________________________________________________________
Address: __________________________________City :______________________Zip: _______________
Phone: ______________________ Fax #: ______________________ E-mail: _______________________
TEAM INFORMATION
Team Name: ___________________________________________________________________________
Age Group, Gender, Division Team: _________________________________________________________
District # _________________
Cal North Team # _________________ League # _______________
League of Registration: ___________________________________________________________________
Team Contact Person: ___________________________________________________________________
Address: ________________________________City :_______________________ Zip: _______________
Phone: ______________________ Fax #: ______________________ E-mail: _______________________
The team listed is cited as violating California Youth Soccer Association Rules as per the Cal North Tournament
Rules and Guidelines and after proper notification has 14 days to pay the $300 fine to the tournament. Failure to
pay on time will result in further action by the District Commissioner.
Please indicate type of Infraction with a checkmark
__________
Late Withdrawal
Supporting documentation:
A photocopy of the tournament list of accepted/rejected teams.
A photocopy of the late withdrawal letter (if sent by team).
__________
Game Forfeiture
Supporting documentation:
A photocopy of the official game card which is signed by the referee or tournament official.
__________
Multiple Applications
Supporting documentation:
A photocopy of the team Application for a Cal North Tournament which was submitted to tournament.
__________
Removal of team for use of falsified or illegal credentials
Supporting Documentation:
A photocopy of questionable credentials (i.e. member pass, roster, guest player form)
A photocopy of any applicable official game card on which the player was listed.
__________
Allowing an ineligible, uncredentialed or improperly credentialed player to participate
Supporting Documentation:
A photocopy of questionable credentials (i.e. member pass, roster, guest player form
A photocopy of any applicable official game card on which the player was listed.
Using any trackable delivery system submit copies of Infraction Report to Offending team.
Using any standard method, submit copies of Infraction Report to the team’s District Commissioner and to the Cal
North Tournament Committee Chair.
RECONCILATION OF INFRACTION.
DATE PAID:
CHECK NUMBER:
DOCUMENTED BY LEAGUE OFFICIAL(NAME):
Cal North Form 2609 Revised 5/12
AMOUNT:
Cal North Tournament Survey
Name of Tournament: _____________________________________________________________________
Location of Tournament: (city) ______________________________________________________________
Specific Venue Location (name of park, school, etc.): ____________________________________________
Team age group: ____________________________
Date of Tournament ______________________
Instructions: Evaluate the areas of the tournament listed below and submit to the Cal North office
RATING:
1.
A = Excellent
B = Good
C = Average
Fields
D = Below Average
A
B
C
D
A
B
C
D
A
B
C
D
Did the field have nets, corner flags and proper markings?
2.
Referees
Was a 3-person system used? Were the referees in proper uniform?
3.
Field Marshalls
Were they on site and identifiable and knowledgeable of Cal North and tournament policies, procedures & rules?
4.
Game Scheduling
A
B
C
D
A
B
C
D
A
B
C
D
A
B
C
D
Good game spacing? Were there minimum 2 hr. rest periods between games?
5.
Facilities
Were there restrooms, adequate parking, concession stand?
6.
Team Correspondence
Were the acceptance notice, rules, maps and schedules received on time?
7.
Overall Tournament Rating
How would you rate this tournament overall? Would you return next year?
8.
Additional Comments
Cal North Form 2611 Revised 5/12
CALIFORNIA YOUTH SOCCER ASSOCIATION
TOURNAMENT INCIDENT REPORT FORM
Incident reports are required for any situation that is out-of-the-ordinary or that could be anticipated as requiring
any further league or Cal North involvement ( for example accident reports, police reports, insurance claims for
loss, damage or liability, or other noteworthy occurrences that took place at the tournament.) This report must
be mailed to the Cal North office within 72 hours of the conclusion of the tournament.
Tournament Name
Tournament Date
Date of Incident
Time of Incident
IF THIS INCIDENT INVOLVES INJURY, PROPERTY DAMAGE OR ANY OTHER POTENTIAL INSURANCE
CLAIM, A CAL NORTH YOUTH SOCCER CASE REPORT MUST ALSO BE SUBMITTED.
In the space below specify in detail the nature of the incident. Attach any supplemental reports and/or
documentation (copies of Referee Sendoff reports, Cal North Case Report, other injury reports, eye witness
accounts, photographs, etc.)
Please include names and phone numbers of eyewitness if possible.
Report Submitted By:
(print name)
Signature:
Title or Position:
Cal North Form 2614 Revised 5/12
Date: