GLENDALE HIGH SCHOOL GIRLS PLAYER INFORMATION

The Undersigned understand that rugby football is a physical sport with the possibility of injury. With that knowledge, the Undersigned hereby accept the risks that accompany participation in rugby football.

The Undersigned agree that they will not hold the City of Glendale, Glendale Youth Rugby or any of its coaches, administrators, officials, staff, representatives, employees, insurers, or re-insurers liable for any and all claims including, but not limited to, injury, sickness, disability, paralysis, or death; that may result from participation in the sport of rugby or from participation with the Glendale High School Girls Rugby Team.

RELEASE AND WAIVER OF LIABILITY: IN CONSIDERATION OF THE PLAYER’S RIGHT TO PARTICIPATE, THE UNDERSIGNED HEREBY RELEASE, DISCHARGE, AND COVENANT NOT TO SUE the City of Glendale, Glendale Youth Rugby or any of its coaches, administrators, officials, staff, representatives, employees, insurers, or re-insurers for any and all claims including, but not limited to, injury, sickness, disability, paralysis, or death; that may result from participation in the sport of rugby or from participation with the Glendale High School Girls Rugby Team.

THE UNDERSIGNED AGREE THAT THIS RELEASE IS BINDING AND EFFECTIVE AS TO THEMSELVES AS WELL AS TO THEIR PERSONAL REPRESENTATIVES, ESTATES, ASSIGNS, HEIRS, AND NEXT OF KIN AND THAT IT APPLIES TO ANY AND ALL LOSS OR DAMAGE INCLUDING, BUT NOT LIMITED TO, INJURY, DISABILITY OR DEATH.

I give permission for the coaches and/or organizers of Glendale Youth Rugby to act as a guardian to my child in the case that my child is in need of medical assistance and I can not be reached.

The Undersigned understand that by signing this release they are giving up substantial rights they would otherwise have to recover damages for losses and they agree that they are doing so voluntarily and without inducement, threat, or duress. The Undersigned agree that they had the opportunity to seek legal advice before signing this release and have either done so, or have voluntarily elected not to and waive this opportunity.

I hereby give permission for the City of Glendale, Infinity Park, and Glendale Youth Rugby to use photographic or video images of my child for marketing and/or promotional purposes only.

Hospitals often cannot treat or care for children without consent from parents or legal guardians. Complete this form in the event your child must be attended to by medical personnel and you can not be immediately contacted to obtain consent.

Consent to Medical Care and Treatment of Minor Children:

I, the natural parent or legal guardian of the rugby participant authorize and consent to medical, surgical and hospital care, treatment and procedures to be performed for my child by a licensed physician, hospital, ATC, or PT when deemed immediately necessary or advisable by the medical professional to safeguard my child’s health. I wave my right of informed consent to medical treatment.

This is to certify that the rugby participant has full permission to travel in a group or independently outside of the City of Glendale’s Infinity Park venue in connection with the Glendale High School Girl’s Rugby Team conducted by the City of Glendale through the Glendale Rugby Football Club.

I understand that the participation in trip activities could involve risk of physical injury, illness, death, or property loss, and despite safety precautions, the City of Glendale cannot guarantee safety thereof, as all risks cannot be prevented. The City of Glendale does not provide health and accident insurance for program participants, and I understand that any medical expenses, property loss, or other personal expenditures that result during or from this travel/trip are to be borne by the participant or by their parent or guardian. I also hereby consent and give authorization to coaches and administrators to secure any emergency medical treatment in the event I am unable to, and I agree to be responsible for the costs thereof.

I further acknowledge that if the above participant is a passenger in another’s private vehicle in connection with this program, that the City of Glendale’s auto insurance does not cover such a private vehicle. I also understand that the City cannot be responsible for assuring the safety and reliability of such private transportation or driver, and I therefore accept the risks and responsibilities associated with such private vehicle travel and activities.

In consideration of the opportunity afforded, with full knowledge and acceptance of the risks associated with this travel, and with full understanding of the above issues/conditions, I hereby release, indemnify, and hold harmless the City of Glendale, its officers, employees, coaches, staff, and agents from all form and manner of risks inherent in such travel, and from all claims and demands of any nature arising from participation in said program, travel, event, or function.