UNC-Pembroke Rugby

 

RELEASE OF ALL LIABILITY CLAIMS

 

 

In consideration of the UNC-PEMBROKE RUGBY CLUB providing instruction to me, attempting to further my knowledge and permitting me to participate in the UNC-PEMBROKE RUGBY CLUB, I, ___________________________________(print name) hereby agree as follows:

 

1.       I hereby covenant not to bring any action legal, equitable, or otherwise, or to make any claim of any nature whatsoever against The University of North Carolina at Pembroke, its officers, trustees, employees, and agents, the UNC-PEMBROKE RUGBY CLUB and its officers, instructors, representatives and any other persons involved with the UNC-PEMBROKE RUGBY CLUB activities, either directly or indirectly, for any personal injury or injuries, including death or property damage which I or others might sustain in engaging in UNC-PEMBROKE RUGBY CLUB activities necessarily or incidentally associated therewith.

2.       I do hereby release and further discharge The University of North Carolina at Pembroke, its trustees, officers, employees, and agents, and the UNC-PEMBROKE RUGBY CLUB, its officers, instructors, representatives and any other persons, either directly or indirectly, of any responsibility or liability of any nature to me for any personal injuries, death or property damage which I may suffer or incur either directly or indirectly as a result of my participation in UNC-PEMBROKE RUGBY CLUB activities.

3.       I MAKE THESE COVENANTS, RELEASES AND WAIVERS KNOWINGLY AND VOLUNTARILY WITH FULL KNOWLEDGE OF ANY EXISTING DANGERS IN TRAINING, PRACTICING, PLAYING, TRAVEL, AND ANY OTHER CLUB ACTIVITIES; WHICH DANGERS I HEREBY FURTHER EXPRESSLY VOLUNTARILY ASSUME.

4.       I further make these covenants, releases, and waivers to bind myself, my executors, heirs, administrators and assigns to the fullest extent.

5.       I do execute this Release with the intent to be legally bound hereby for myself and on behalf of my heirs, administrators, executors and assigns.

 

 

 

Signature________________________________________

Date____________________________________________

UNCP Student ID #________________________________

Email Address____________________________________

Phone # _________________________________________

 

PARTICIPATION AGREEMENT FOR UNC-PEMBROKE RUGBY CLUB

                The UNC-PEMBROKE RUGBY CLUB involves strenuous physical activity.  Health professionals recommend that all participants complete a physical exam or have a doctor’s approval prior to beginning any exercise program and strongly urge all participants over the age of 45 to have a graded exercise test prior to beginning any exercise program.

Participation in the UNC-PEMBROKE RUGBY CLUB involves strenuous physical activity including running and cardiovascular training.  Possible injuries include, but are not limited to, muscle strains, back injuries, sprains, and more rarely, broken bones, strokes, cardiac malfunction, or other types of catastrophic injury.  All participants must access their physical condition and the possibility of injury.

                The safe conduct of any group activity, such as the UNC-PEMBROKE RUGBY CLUB, is dependent upon the individual actions of each member of the group.  The participant has an obligation to refrain from dangerous or disruptive activity that might endanger the participant or any other member of the group.  The use of drugs, alcohol, or any other substances that might be dangerous or detrimental to the participant’s performance as a member of this organization is strictly prohibited.  In addition:

 

A.      The undersigned understands that he/she is fully responsible for any and all medical expenses that he/she might incur as a result of his/her participation in any of the UNC-PEMBROKE RUGBY CLUB activities.

B.      The undersigned certifies that he/she has adequate medical/hospital insurance coverage that will cover any and all medical expenses resulting from his/her participation in any of the UNC-PEMBROKE RUGBY CLUB activities.

C.      The undersigned agrees that any travel conducted in conjunction with UNC-PEMBROKE RUGBY CLUB activities is voluntary and discretionary.  THE UNIVERSITY DOES NOT ASSUME ANY LIABILITY FOR SUCH VOLUNTARY TRAVEL.

 

INSURANCE COMPANY_____________________________________________

POLICY #_________________________________________________________

 

 

1. The undersigned further agrees to conduct himself/herself in a SAFE and PRUDENT MANNER at all times while participating in the UNC-PEMBROKE RUGBY CLUB activities.
2. The undersigned has read and understands the importance of securing a physician’s approval of the undersigned’s participation in the UNC-PEMBROKE RUGBY CLUB activities prior to participation in those activities.
3. The undersigned has read this Agreement and fully understands the risks involved with the UNC-PEMBROKE RUGBY CLUB activities and willingly agrees to accept and assume those risks during this club sport program and further agree to exonerate and save harmless UNC-PEMBROKE RUGBY CLUB, its officers, trustees, agents and employees from any and all liability, claims, causes of action or demands of any kind and nature whatsoever which may arise by or in connection with the undersigned’s participation in and activities related to the UNC-PEMBROKE RUGBY CLUB.
4. The undersigned agrees to follow any verbal and/or written instructions provided by the coaches and/or supervisors during each UNC-PEMBROKE RUGBY CLUB activity.

 

 

 

_________________________________________                                 ________________________

Participant’s signature                                                                                        Date