Forms to Request Payments, Refunds or Credits
Extended Payment Plan Request Form
Use to request a 9-payment or other plan for the Competitive Program
This link will take you to our Financial Assistance page
Use to request a credit or voucher code for Comp registration
For Comp, receive a voucher code prior to registration or a credit adjustment after
For Rec, receive a voucher code prior to registration
Request for Refund or Credit Form
Use to request a refund or credit due to season-ending injury or moving. Download and fill the form and submit it with the required documents (ex., doctor's letter).
Email to: email@example.com
or Mail to: PO Box 410301, Melbourne, FL 32941
Player Medical Release & Registration Forms
Waivers for Return-to-Play (COVID-19)
Parks & Rec Waiver - All players
SCUSC Waiver - All players
FYSA Waiver - players whose team plays in GCF or BYSL
Injuries and Insurance Forms and Links
All registered players are covered by supplemental medical insurance provided by the organization under which they play. Comp players are covered through FYSA, Comp NPL players are covered through FYSA and U.S. Club, Rec players in BYSL are covered through FYSA, Rec in-house players are covered through USSSA.
If your player is injured during a game or at practice, you can file a claim to help cover the costs of medical treatment.
Player injuries must be reported to the Club. Complete the form electronically and submit it to firstname.lastname@example.org or give handwritten reports to Directors. The fillable PDF can be typed in and saved.
FYSA - GCF and BYSL Teams
FYSA Notice of Possible Head Injury/Concussion
To be filled and presented to the Club at the time of the incident or shortly thereafter.
Who is covered? What is covered?
US Club - ECNL, ECNLRL and FCL Teams
US Club Insurance Information page
Claims Page with Claim Form and instructions.
US Club Insurance Claim Verification Form (#R011, fillable PDF).
The team coach or manager will submit this form for processing when a parent submits an insurance claim for one of your players. This information provides verification of the player's injury prior to submitting the claim to the insurance company for review.
USSSA - In-House Rec Teams
USSSA Insurance - Contact email@example.com
Space Coast United Soccer Club | P.O. Box 410301, Melbourne, FL 32941 | firstname.lastname@example.org