Northern Colorado Soccer Club

W9 Form

Please download and fill out the interactive W9 form, fill it out and attach it in the following field.

Certification Child Abuse Statement

Colorado Youth Soccer (CYS) and its organizational members (Member Clubs), have a great deal of concern about the safety and abuse of children. As a person who is interested in the well being of children, we believe you are entitled to know how our organization is dealing with this critical issue. In addition, as an applicant for a volunteer/staff position you're your organization, you need to know the measures we employ to protect children in our care, as well volunteers/staff, from this serious problem. CYS has adopted the United States Youth Soccer Association (USYSA) KidSafe program and it is our intent to make every reasonable effort to deny from participation any person who has been convicted of a crime of violence or a crime against another's person that would bring unnecessary risk to the health or safety of CYS or member club soccer program participants. CYS and Member Clubs will not tolerate the abuse of any child and will make an active effort to prevent child sexual abuse in our programs. We attempt to screen out molesters through a background check. We try to structure our activities so that volunteers/staff are not left alone with children. We take any allegations by children and others very seriously. We will refer allegations to the State law enforcement authorities for investigation and will fully cooperate in any investigation. CERTIFICATION / CONSENT FOR CRIMINAL BACKGROUND CHECK / AUTHORIZATION / WAIVER / RELEASE / INDEMNITY I certify that all of my statements on this application, the information provided, and attachments hereto, are true and complete to the best of my knowledge. I also certify that I have not withheld any information that would affect my application unfavorably, if disclosed. I understand that any omission of facts or misrepresentation will result in my elimination from consideration for any volunteer or staff position with Colorado Youth Soccer (CYS) or its Member Clubs or, following acceptance of service, may be cause for the immediate termination of my relationship with CYS or its Member Clubs. I further certify that I understand the intent of CYS is to exclude from program responsibility any person with a legally documented history of child molestation or other record that would bring an unnecessary risk to the health and safety of the programs participants. I acknowledge that CYS or its Member Clubs will, and I hereby give my unconditional permission to CYS and its Member Clubs to, inquire as deemed necessary into my prior employment, experience, relationships with others and background, including criminal background checks which may contain arrest and conviction data, plea bargains and any type of probation including deferred adjudication or "pre-trial diversion." I give my permission for the Colorado Youth Soccer or Member Clubs to obtain information relating to my criminal history record from a background check vendor and/or licensed private investigator. I understand that this information will be used, in part, to determine my eligibility for a staff / volunteer position(s) with the specific organization. I also understand that as long as I remain an employee or volunteer here, the background history checks may be repeated at any time. I understand that a procedure is available for clarification and that I will have an opportunity to review the criminal history if I dispute the record as received. I further understand that driver license suspension or revocation must be reported to CYS or the member club and that transporting any member of CYS or the member club is prohibited until my driving privileges are re-instated by proper authorities. I understand that CYS or the member club can notify key organization or team members in the event of suspension or loss of license. I hereby waive any right to assert that such investigation or request constitutes an invasion of my privacy. I recognize that such inquiries are in the interests of all persons involved in CYS activities, and I fully consent to such investigations. I, the undersigned, for myself, my heirs, executors, administrators, and representatives, do hereby remise, release and forever discharge and agree to indemnify and hold harmless any involved background check vendor and/or licensed private investigator, Colorado Youth Soccer (CYS), its directors, officers, employees, volunteers, agents and representatives, its Member Clubs and sponsors, and their directors, officers, employees, volunteers, agents and representatives, as well as any third parties, if any, that CYS or its Member Clubs contact, directly or indirectly, regarding my application to, or future services with, CYS or its Member Clubs, from and against any and all causes of actions, suits, liabilities, costs, debts and sums of money, claims and demands whatsoever, and any and all related attorneys' fees, court costs, and other expenses resulting from the investigation of my background in connection with my application to become a volunteer/staff member. I further agree to conform to the rules, regulations, and policies of CYS and its Member Clubs and I understand that my service/employment and compensation, if any, can be modified or terminated, with or without notice or cause, at any time, at the option of either CYS and its Member Clubs, or myself. I understand that no representative of CYS has the authority to enter into any agreement for service/employment for any specified period of time, or to make any agreement contrary to the foregoing. I understand and agree that CYS or its Member Clubs may, in their sole discretion, decline to accept my application for volunteer/staff services with or without cause. I ACKNOWLEDGE THAT I HAVE READ AND FULLY UNDERSTAND THE ABOVE CERTIFICATION / CONSENT FOR CRIMINAL BACKGROUND CHECK / AUTHORIZATION / WAIVER / RELEASE / INDEMNITY, AND THAT I ACCEPT AND COMPLETE THIS FORM VOLUNTARILY.