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we need in order to register you to play in the Southern California Rugby Union for the San Diego Armada RFC. All Fields are Required except "CIPP Number", "Cell Phone" and "Work Phone". Wait until the screen redraws before continuing. | ||||
| Payment: | CIPP Number (if known) | Date Of Birth MM/DD/YYYY | ||
| Last Name | First Name | Middle Initial | ||
| Address | City | State | Zip | |
| Home Phone | Cell Phone | Work Phone | ||
| E-Signature (Type Full Name) | ||||
WAIVER AND RELEASE OF LIABILITY, AND RELEASE FOR SAN DIEGO ARMADA RUGBY FOOTBALL CLUB (SDARFC) In consideration for being allowed to participate in any rugby competition (the Activity) conducted under the auspices of the SDARFC, its member unions, clubs, organizations and individuals, I agree that: 1. I understand the dangers that may be caused by my own actions or inactions, the actions or inactions of others participating in the Activity and the conditions under which the Activity is conducted. I understand the nature of the Activity and acknowledge that I am qualified to participate in such Activity. I further acknowledge that I am aware that the Activity will be conducted in facilities open to the public during the Activity. I further agree and warrant that, if at any time, I believe conditions to be unsafe, I will immediately discontinue further participation in the Activity. 2. I acknowledge that I have a medical insurance policy in my name that has a minimum of $100,000 in medical coverage. Such insurance will be my primary source of payment should medical treatment be necessary as a result of my participation in the Activity. Please Initial: 3. I FULLY UNDERSTAND that: (a) the Activity involves risks and dangers of SERIOUS BODILY INJURY, INCLUDING PERMANENT DISABILITY, PARALYSIS AND DEATH (“Risks”); (b) there may be other risks and social and economic losses either not known to me or not readily foreseeable at this time; and (c) I FULLY ACCEPT ALL SUCH RISKS AND ALL RESPONSIBILITY FOR LOSSES, COSTS AND DAMAGES incurred as a result of my participation in the Activity. 4. I HEREBY RELEASE, DISCHARGE, COVENANT NOT TO SUE AND AGREE TO HOLD HARMLESS SDARFC, its respective administrators, members, directors, agents, officers, volunteers and employees, local organizing committees, other participants, any sponsors, advertisers, if applicable, owners and lessors of premises on which the Activity takes place (each considered one of the “Releasees” herein) from all liability, claims, demands, losses, or damages on account caused or alleged to be caused, in whole or in part by any act or omission of the “Releasees” in connection with the Activity or otherwise, including rescue operations, and further agree that if, despite this release, I or anyone on my behalf makes a claim against any of the Releasees named above, I WILL INDEMNIFY, SAVE AND HOLD HARMLESS EACH OF THE RELEASEES FROM ANY LITIGATION EXPENSES, ATTORNEYS FEES, LOSS LIABILITY, DAMAGE OR COST ANY MAY INCUR AS THE RESULT OF SUCH CLAIM. 5. I agree to abide by all International Rugby Board (IRB), USA Rugby (USAR), International Gay Rugby Association and Board (IGRAB), Southern California Rugby Football Union (SCRFU), territorial and local area union rules and regulations, including to be bound by the arbitration procedures therein, that I am aware of and understand, for any dispute regarding my right to participate in the Activity, as set forth in the Bylaws of the SDARFC, as they are amended on a periodic basis, which I understand are available by request or on the SDARFC website ( http://www.sdarmada.org ). 6. I affirm that I am not suspended or banned from play or participation by any club, local area union, territorial union, or national union. 7. I authorize the SDARFC to verify my citizenship status with the appropriate governmental agencies. 8. I am aware that the SDARFC has the right to revoke or deny membership, and therefore my eligibility to play, in the event of any violation of the aforementioned statements. I HAVE READ THIS AGREEMENT, FULLY UNDERSTAND ITS TERMS, UNDERSTAND THAT I HAVE GIVEN UP SUBSTANTIAL RIGHTS BY SIGNING IT AND HAVE SIGNED IT FREELY WITHOUT ANY INDUCEMENT OR ASSURANCE OF ANY NATURE AND INTEND IT TO BE A COMPLETE AND UNCONDITIONAL RELEASE OF ALL LIABILITY TO THE GREATEST EXTENT ALLOWED BY LAW AND AGREE THAT IF ANY PORTION OF THIS AGREEMENT IS HELD TO BE INVALID THAT THE BALANCE, NOTWITHSTANDING, SHALL CONTINUE IN FULL FORCE AND EFFECT. | ||||
| Player Name | Date | Liability Waiver | ||
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