HAKA RUGBY CAMP REGISTRATION
Email address *
Name of Camp? (e.g.. Haka Rugby Camp JAPAN) *
Your answer
Player Name *
Your answer
What is the name of your current Rugby Club?
Your answer
Date of Birth? *
MM
/
DD
/
YYYY
National Security Number/Codice Fiscale?
Your answer
Do you take Medication? *
Your answer
Do you have any Allegies? *
Your answer
Your answer
Your answer
Parents Name *
Your answer
Parents Contact Number *
Your answer
Home Address *
Your answer
Contact Email *
Your answer
I, declare that the player is in good standing with the membership and the medical examination for the 2017 season. We accept no liability on the part of HAKA RUGBY CAMP about the physical safety of participants and staff, before, during and after the camp. *
MEDIA - I, authorize the HAKA RUGBY CAMP in filming and photographing of the participants throughout the duration of the camp and allow them to use for their social media and website. *
CONDUCT - The coaches are responsible for the care and good discipline of participants while they are at the Haka Rugby Camp (and not under the control of a Parent or Guardian).It is a condition of remaining on the Camp that the Parent/s and the participant accept the Camp regime, the maintenance of good order, discipline and courtesy towards the coaches and fellow attendees. Should a participant be removed from the Camp because of unacceptable behaviour or sign i cant breach of good conduct, the Parent/s accept/s that no refund will be made. *
INJURY & INSURANCE - The Parent/s accept/s that no claim may be made against Haka Rugby Global, or any coach, for injury or loss, unless this specially results from an act of omission or negligence on the part of the Haka Rugby Camp or the Coach.It is recommended by Haka Rugby Global that the Parent/s ensure that they take out personal injury and third party liability insurance on behalf of the participant. *
PROTECTIVE EQUIPMENT - Mouth guards are compulsory for all rugby sessions. Use of items such as head/shoulder protection is at the discretion of parents and must be in accordance with the sport’s rules. *
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