Massachusetts Youth Soccer
Return to Soccer Activity Review and Compliance Waiver
The undersigned, hereby represents, warrants and acknowledges that I have read and
understood my responsibilities as a Coach/Volunteer according to the Massachusetts
Youth Soccer COVID 19 Soccer Protocols prior to participating in any town program,
club, or league soccer related activities. This includes, but is not limited to, individual or
team practices, clinics, training, games, tournaments, meetings or classes.
I attest that the information I am providing below is true and accurate. Prior to
participating in any soccer related activities I will ensure that I have not experienced any
of the following symptoms within the last 48 hours: (please place an X in each box to
indicate you have read.)
❏ Fever (over 100.4 degrees fahrenheit) Temperature will be taken before every
❏ Shortness of breath, or difficulty breathing
❏ Muscle aches
❏ Sore throat
❏ Loss of smell or taste, or a change in taste
❏ Nausea, vomiting or diarrhea
Place an X in each box below indicating you have read and acknowledged each of the
following statements as being true and correct:
❏ The player has not been in close contact with anyone who has exhibited
symptoms of COVID-19 in the last 10 days.
❏ The player has not had contact with anyone who has had a confirmed case of
COVID-19 in the last 10 days.
❏ The player is not restricted from participating by a healthcare provider.
❏ The player has not traveled in the past 10 days or is not subject to quarantine by
the Commonwealth of Massachusetts travel advisory. If so, all of the necessary