Please complete this form only if either of the following applies:

• Someone other than a parent or legal guardian may pick up your child from UCFC activities; or

• Your child has permission to arrive at or leave training independently (U15/U17 only).

This authorization remains in effect for all sessions your child attends during the August 2026 Training & Tryout Week unless you notify us in writing of any changes at ucfc.nyc@gmail.com.

IMPORTANT: Independent dismissal is only available for players born in 2010–2013 (U15 and U17 age groups). Players born in 2014-2022 (groups U5–U13) must be picked up by an authorized adult at every session, regardless of this form.

To change or revoke this authorization at any time, email ucfc.nyc@gmail.com with subject line "Dismissal Change – [Player Name]".