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PARTICIPANT waiver
RELEASE OF LIABILITY - ASSUMPTION OF RISK
(READ BEFORE SIGNING)
In consideration of my child being allowed to participate in the American Rugby Factory d/b/a Reign Rugby Academy (“Reign Rugby”) On-Field Activity and the related events and activities, I, the undersigned, individually and on behalf of my child, acknowledge, appreciate, and agree that:
1. I understand that my child’s participation in this event demonstrates my and my child’s acceptance of the risks inherent in such activities, including physical injury, death, property damage, and any other risks. I understand that even though Reign Rugby’s rules, equipment, training, and discipline are designed to avoid any injury, the risk of injury from On-Field Activity is significant.
2. I, individually and on behalf of my child, knowingly and freely assume all such risks, both known and unknown, even if arising from the negligence of the Releasees (as defined below), and assume full responsibility for such participation.
3. I, individually and on behalf of my child, willingly agree to comply with all security measures, policies, and guidelines of the Reign Rugby and any venue where the program and related events and activities are held.
4. I, for myself and my child, and further on behalf of my and my child’s heirs, assigns, personal representatives, and next of kin, hereby release, indemnify, and hold harmless the Releasees, defined as Reign Rugby and all of its members, managers, agents, employees, coaches, commissioners, officials, volunteers, and other acting on Regin Rugby’s behalf, and all parties for whom they may be responsible, and, if applicable, owners and lessors of premises used for the event (collectively the “Releasees”), with respect to any and all injury, disability, death, or loss or damage to person or property, whether arising from the negligence of the Releasees or otherwise, to the fullest extent permitted by law, directly or indirectly, related to, arising from, in connection with or attributed to or resulting from my or my child’s on-field activity and the related events. I, for myself and my child, further agree to defend, indemnify, and hold harmless the Releasees from any damage, injury, expense, costs, suit, claims, or liability of any kind (“loss”) sustained by me, my child or by any third person arising out of or in any way connected with my or my child’s on-field activity and the related events, regardless of the cause thereof and regardless of my or my child’s compliance with the applicable rules, including any loss which is attributed to or caused by the condition or use of the field facilities, any activity occurring at the field facilities, or by any fault, negligence, or strict, absolute, or other liability of the Releasees. I, for myself and my child, further agree that I, for myself and my child, will not institute, prosecute or any in way aide in the institution or prosecution of any claim asserted against the Releasees.
5. If any provision of this Waiver shall be prohibited by or invalid under applicable law, such provision shall be ineffective only to the extent of such prohibition or invalidity, without invalidation or affecting the validity or enforceability of any other provisions of this Waiver.
I HAVE READ THIS RELEASE OF LIABILITY AND ASSUMPTION OF RISK AGREEMENT. I FULLY UNDERSTAND ITS TERMS AND UNDERSTAND THAT I, INDIVIDUALLY AND ON BEHALF OF MY CHILD, HAVE GIVEN UP SUBSTANTIAL RIGHTS BY SIGNING IT. I SIGN IT FREELY AND VOLUNTARILY WITHOUT ANY INDUCEMENT.
PERMISSION – USE OF LIKENESS AND MEDICAL TREATMENT
(READ BEFORE SIGNING)
I, HAVE READ THIS AGREEMENT AND I FULLY UNDERSTAND ITS TERMS. I SIGN IT FREELY AND VOLUNTARILY WITHOUT ANY INDUCEMENT.
I, the undersigned, individually and on behalf of my child, grant full permission to American Rugby Factory d/b/a Reign Rugby Academy and its authorized agents to use all photographs, videotapes, motion pictures, recordings, or any other record (collectively referred to as “records”) of my child resulting from my child’s participation in the Reign Rugby On-Field Activity, and the related events and activities. In doing so, I understand that the those parties will have the irrevocable right to document, copy, edit, display, reproduce, use and re-use in any manner, on a worldwide basis, in perpetuity, on all forms of media including but not limited to film, television, and electronic media and in all means of distribution and publication, the records without any form of compensation to me for such use.
I, HAVE READ THIS AGREEMENT AND I FULLY UNDERSTAND ITS TERMS. I SIGN IT FREELY AND VOLUNTARILY WITHOUT ANY INDUCEMENT.
Participant name:
Participant date of birth:
Parent/Guardian Name (if participant is a minor):
Relationship to Participant (if participant is a minor):
Phone Number(s)
Parent/Guardian Permanent Address
Child Permanent Address if Different
Participant Allergies (Please specify allergies):
Photo & Media Release (Optional) I grant AMERICAN RUGBY FACTORY permission to use photographs, videos, or recordings of me (or my child) for promotional or educational purposes.
No
Yes
Agreement & Signature I certify that I have read, understood, and voluntarily signed this Waiver and Release of Liability. I acknowledge that this agreement is legally binding.
Type Name to Represent Signature (Parent/Guardian Signature if participant is under 18)::
Emergency Contact Name:
Emergency Contact Phone:
Health Insurance Provider:
Policy Number:
Primary Physician Name:
Primary Physician Contact:
Important Notes: This waiver must be signed before participating in any AMERICAN RUGBY FACTORY activity. Participants without a signed waiver will not be allowed to train or compete. Parents/guardians of minors must sign on behalf of their child. Reign Rugby is the commercial name for American Rugby Factory.
I accept the conditions above
SUMBIT