Illinois Youth Soccer Association Olympic Development Program
Secure ODP Enrollment Form - 2008-2009
The US Youth Soccer Olympic Development Program is a national program to identify and
develop youth players to represent their State, Region, and Country in soccer competition.
Registration Fee: $50.00 (you may pay by check or credit card)
All ODP fees and payments are non-refundable.
ODP Enrollment Fee Deadline: Friday, October 24th, 2008

The $50.00Enrollment Fee is an ODP administrative and t-shirt fee only! Enrollment fee does not include tryouts, trainings, tournaments, camps and/or any other ODP events.

It's Secure! IYSA uses Secure Socket Layer (SSL) technology to transmit your data to the web server.

Required Fields are Marked with a "*"
NOTE! All ODP information will be sent by email to the Email Address provided below.
Only persons for whom the IYSA has this current ODP Enrollment Form
and required documents on file will receive ODP information.

Player Information
Player's Name* First Last
Birthdate* & Gender* mm dd yyyy   Boy Girl
Street Address*
City, State & Zip* ,   
Home Phone* ( ) -
Parent/Guardian Email Address*
Confirm Parent/Guardian Email Address*
Alternate Email Address
Confirm Alternate Email Address
Position* Field Player Goalkeeper
Are you a US Citizen?*
 Yes No
High School or College (if applicable)
High School Graduation Year*
IYSA League Affiliation
Current Club Team
Parent/Legal Guardian Information*
Mother's/Legal Guardian's Name
Father's/Legal Guardian's Name
Parent/Legal Guardian Home Phone ( ) -
Parent/Legal Guardian Work/Mobile Phone ( ) -
Payment Information
A limited number of scholarships are available for financial hardship cases for Illinois ODP events only. If a scholarship
is needed in order to participate in the Illinois ODP process, please call the IYSA office for the required documents.
Method of Payment (fee is $50.00)* Check  Credit Card (Mastercard or Visa)
Credit Card #
Credit Card Exp. Date /
Name on Card
Cardholder's Street Address
Cardholder's Zip Code

This program is duly authorized through the United States Soccer Federation as being part of the Olympic Development Program (ODP). ODP Teams are based on the January 1st Birth Years in compliance with U.S. Youth Soccer & FIFA Circular # 504.

By checking the box at left, We hereby acknowledge and certify via electronic submission/signature that we are the parents/legal guardians for the player/participant listed herein. Further, We (player and parents/legal guardians) further agree to abide by the rules, regulations, policies and decisions of the Illinois Youth Soccer Association (IYSA) and to participate in the Illinois Olympic Development Program as determined by the IYSA. We also certify that the information provided herein is complete and accurate. We grant permission to the IYSA to use any and all photographs, videography and information provided herein and throughout the ODP process for the purpose of conducting business for the Illinois Youth Soccer Association. We agree that the Illinois ODP Enrollment and all ODP Program fees are non-refundable. We understand that the player will not be permitted to participate in the ODP process until Illinois Youth Soccer Association is in receipt of the player’s IYSA ODP Enrollment Form, Illinois Youth Soccer Emergency Medical Release and Liability Waiver and Birth Certificate or legal proof of age. We acknowledge and fully understand that the player is engaging in activities that involve risk of injury, including permanent disability or death, and severe social and economic losses. We hereby give our consent for emergency medical care and accept personal responsibility for the damages. We also agree to save and hold harmless, to indemnify and not to sue the Illinois Youth Soccer Association, its directors, officers, employees, coaches, managers, agents, sponsors and associated personnel including those of its affiliated organizations, and the owners and lessors of premises used to conduct the event (hereinafter collectively referred to as releasees) from all liability, loss, cost, claim or damage whatsoever, including death or damage to property, caused, or claimed to be caused, and any injury or accident resulting from participation or alleged to be caused in whole or in part by the negligence of the releasees.

I/we (above indicated) hereby acknowledge that I/we have reviewed this form and caused it to be electronically executed with the intent to be bound to the terms contained herein*.

  

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