Membership Consent Form – Old Belvedere RFC

Player*

Parent/Guardian*

Team*

Consent I hereby apply/reapply for my child to become a member of Old Belvedere Mini Rugby Club and I consent for his/her participation in coaching, matches and tournaments. I agree that photographs of my child/myself at training, playing matches or representing the Club maybe posted on the Club website or used in promotional documentation. I recognize that rugby can be a dangerous contact sport and I accept and appreciate the risks involved and shall not hold the club responsible for any injury that may occur. I confirm that my child appreciates the need to and agrees to wear a properly fitting gum shield at all times during training and matches. The Club has a strict policy NO GUM SHIELD NO RUGBY

I also authorise for OBRFC Mini/Youth Rugby to hold all and any necessary data required for my child (named above) and their registration with the IRFU for as long as he/she continues to be a member of the Club. I also consent for OBRFC to share my contact details and child’s name with Teamer.net, IRFU, Whatsapp, Mailchimp.com and any such other relevant applications/associations/organisations as the club considers necessary for the purposes of registration and communication during the period that my child is playing with OBRFC Mini/Youth Rugby. I understand that I may write to the Club at any time to request to have my child’s contract with OBRFC terminated and to have my child’s data removed from the OBRFC database, should I wish to do so.

Behaviour

I confirm that my child has agreed to dress and behave in and appropriate manner at all times while representing the Club. He/She will cooperate fully with the Old Belvedere coaches and obey without question the decision of referees at matches. He/She agrees to wear the Club uniform and to be punctual for matches, and to notify the coordinator or coach if unavailable.

Medical Consent:

In the event of illness or accident which requires emergency hospital treatment, I hereby authorize one of my Childs Team Coaches to sign on my behalf any written consent form which is required by any hospital authorities/doctor, if the delay required obtaining my signature is considered inadvisable by the doctor/surgeon concerned. I further confirm that I have provided my child’s coaches with details of any known allergies or sensitivities (i.e. penicillin/nuts) or any other medical issues of which than Club should be aware

I have read the terms of my membership of Old Belvedere Rugby Club and understand and agree to be bound by them.

Signed (Player)*

I hereby declare that I am the legal parent/guardian of the above named child, Signed (Parent/Guardian)*

Date*

Are you human?*

This field should be left blank