This form & waiver are designed for any and all activities and events that this participant engages in through his/her participation in Trumbull Youth Rugby Organization. This includes practices, training, matches, games, competitions, tournaments, and all activities and events that are connected with his/her participation in Trumbull Youth Rugby Organization. This form and waiver must be completed by the legal parent/guardian of the participant prior to participation.
I attest that I am the parent and/or legal guardian of the participant. I am fully aware of, and appreciate, the risks, including the risk of serious injury, permanent disability, damages and losses, and/orl death associated with participation in rugby activities and events, including but not limited to: practices, training, matches, games, competitions, tournaments, and other rugby events. I agree on behalf of myself, my heirs and personal representatives, that Trumbull Youth Rugby Organization, as well as agents, officers and directors of those organizations, and any towns, schools, and/or organizations that provide usage of field space with respect to these Rugby activities and events, together with any coaches, officials, volunteers, and employees working in connection with these rugby events, and any rugby membership organizations in which Trumbull Youth Rugby Organization is a member, shall not be held liable for any injury, loss of life or other loss or damage as a result of my child’s participation in these rugby events and activities.
I attest that my child/this participant has health insurance. I am aware that Trumbull Youth Rugby Organization carries group accident medical insurance which is secondary or excess to my insurance which is considered primary insurance. Further, I agree to notify in writing my head coach of any medical claim from participation as soon as reasonably possible. I understand that the registration fee is not a premium for insurance and that deductibles may apply.
I attest that my child/this partcipant is in good health and has been found physically capable of participating in the sport of rugby. If my child has a medical/physical issue that could impact his/her play in rugby, I will provide additional written notice, setting forth any specific issue, condition, or ailment, in addition to what is specified above, that my child has or that may impact my child's participation in the rugby program. I further give my consent to have a trainer, licensed medical professional, licensed medical doctor and/or dentist, and/or any emergency medical care professional/unit to provide medical assistance and/or treatment to my child, and agree to be financially responsible for the reasonable cost of any such.
I understand and agree that my child's name and date of birth will be shared with other teams as a form of a roster for any game day competition. I understand and agree that my child's name and date of birth will be shared with the Rugby Connecticut Board and any of its designees.
Dispute Resolution/Severability: I hereby agree that binding arbitration shall be used in lieu of any litigation. I also understand and agree that if I contest any decision or ruling of Trumbull Youth Rugby Organization and seek other recourse, that I will reimburse Trumbull Youth Rugby Organization for all legal fees and expenses it reasonably incurs. If any portion of this agreement/form shall be deemed unenforceable, the remainder shall remain in full force and effect.
I hereby give my consent for my child/this participant to participate in rugby training and activities with Trumbull Youth Rugby Organization based on these conditions. By my signature, I confirm that I have read, fully understand and voluntarily agree to be bound by all of the above, and that all information provided by me is true and accurate.
