Waiver

Parental Consent

Participant / Player Name

First Name

Last Name

Date of Birth

MM

DD

YYYY

Age

Permission

I, the parent / guardian of the child named above, herby give permission to activities and events directed by Rugby101 Kiwi Warrior sports. I understand that there is an inherent risk of injury in sports, particularly contact sports. Such injuries may include, but are not limited to, concussions, such as traumatic brain injury, and injuries to bones, ligaments, neck, spine or internal organs. I understand all risks involved and expressly agree to accept all risks existing in contact sports in which my child will be participating. Rugby101 Kiwi Warrior, its parent corporation, or any of its employee will not be liable in both their individual and corporate capacity, for any and all liabilities that may occur while participating in activities or events.

Parent / Guardian Name

First Name

Last Name

Email

Date

MM

DD

YYYY

Agreement

I agree that by submitting this form I have read and understand the above terms and conditions.

Parent/guardian Consent