NG 2016 Roster Exception Form

AYSO National Games 2016
Roster Exception Form For use when one or more players qualify as an exception to the National Games Team Formation Policy.
Complete and submit this form with the team roster by February 1, 2016. S/A/R ____ / ______ / __________
Gender B _____G_____ Age Division BU-­‐________ GU-­‐________
Head Coach Name: _______________________________________________________________________________
Exception Players Information:
Player Name
Note: these players must be listed on an attached eAYSO roster
AYSO ID Number
a, b, c, d, e, f
Exception Category
1, 2, 3
A, B, C
Registration and Participation: The above player(s) were registered but unable to participate in a minimum of one-­‐half of the games for which they were eligible during the 2015-­‐16 primary season for the following reason(s):
a. Serious illness r b. Soccer-­‐related injury r c. Change of address (moved to new region) r d. Parental custodial rights r e. Conflict with secondary/HS rules r Other r Explanation:_________________________________________________________
1. Playing Up: The above player(s) are being allowed to play up one age division for the following reason.
A. The player played up in that division during the primary season.
B. Region does not have enough players in the team's age division and prefers not to borrow guest players.
C. Other (explain): _______________________________________________________________________________________
2. Playing Down: The above player(s) are being allowed to play in the age division which matches their age,
however it is one age division lower that they participated in the primary season for the following reason.
A. There was insufficient number of players to field regional competition in their regular age division.
B. The region required the player(s) to play up due to middle or high school rules.
C. Other (explain): _______________________________________________________________________________________
3. Guest Players: Region has exhausted all means to field a full roster from players within our region and have invited
the above "guest" player(s) from another region/area. The eAYSO roster from guest player(s) region is attached.
Signatures Required: Registration and Participation Special Circumstances -­‐ Regional Commissioner Exception # 1 -­‐ Playing Up -­‐ Regional Commissioner
Exception # 2 -­‐ Playing Down -­‐ Regional Commissioner, Area Director and Section Director
Exception # 3 -­‐ Guest Players -­‐ Regional Commissioner, Guest Player(s) Regional Commissioner,
Area Director and Guest Players Area Director
I certify that the reasons listed above for these players are true. I understand that rosters will be independently verified.
Regional Commissioner Name
Regional Commissioner Signature
Area Director Name
Area Director Signature
Section Director Name
Section Director Signature
Guest Player(s) Regional Commissioner Name
Guest Player(s) Regional Commissioner Signature
Guest Player(s) Area Director Name
Guest Player(s) Area Director Signature
AYSO National Games, Attn Registrar
Mail to: 19750 S. Vermont Ave., Suite 200
Torrance, CA 90502
Email to: [email protected]
NSTC USE ONLY: Rec'd:___/___/____ Approve:_____ Decline:_____ Reason:___________________________