SUMMER FLAG RUGBY REGISTRATION

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, the 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 in Glendale Youth Rugby and its 2026 Summer Flag Rugby Program.

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 in Glendale Youth Rugby and its 2026 Summer Flag Rugby program.

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 understands 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 agrees that they had the opportunity to seek legal advice before signing this release and have either done so or had 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.

I will pay the program fee by my child’s second practice. Refunds after practice has started are given a $10 administrative fee.

e fee.

INHERENT RISK ACKNOWLEDGMENT

I, the undersigned parent/legal guardian of [Child’s Name], acknowledge and agree to the following terms regarding my child’s participation in Glendale Raptors Rugby Club programming.

INHERENT RISK ACKNOWLEDGMENT

I understand that rugby is a physical sport that carries risks of injury, disability, and death. I accept these risks on behalf of my child and allow their participation in the sport.

RELEASE AND WAIVER OF LIABILITY

In consideration of my child’s right to participate, I release and hold harmless the City of Glendale, Glendale Rugby Football Club, its coaches, staff, officials, representatives, employees, and insurers from any claims related to injury, illness, disability, paralysis, or death that may arise from participation in our programs.

MEDICAL CONSENT & TREATMENT AUTHORIZATION

I authorize Glendale Raptors Rugby Football Club medical staff, coaches, and organizers to act on my behalf if my child requires medical assistance and I cannot be reached. I consent to medical, surgical, and hospital care, including treatment by licensed physicians, athletic trainers (ATCs), or physical therapists (PTs) when deemed necessary. I waive my right to informed consent at the time of treatment.

HIPAA AUTHORIZATION

I consent to the use and disclosure of my child’s Protected Health Information (PHI) by Glendale Raptors Rugby Club staff for:

• Treatment coordination among athletic trainers, coaches, physicians, and healthcare providers.
• Communicating my child’s participation status for practice and competition.
  Authorized individuals include Glendale Raptors Rugby Club Sports Medicine staff, coaches, operations staff, and affiliated third-party medical providers.
  
  

HYDRATION SUPPLEMENT CONSENT

I consent to Glendale Raptors Rugby Football Club staff administering electrolyte replacements or other hydration supplements to my child when necessary. I understand that:

• Only safe, commonly used hydration supplements will be provided.
• No prescription or performance-enhancing substances will be given.
• My child may decline supplements at any time.
• The staff will use their best judgment but are not liable for unforeseen adverse reactions.
  
  

By signing below, I acknowledge and agree to these terms on behalf of my child.