WASHINGTON RENEGADES RFC
FALL 2017 MEMBER & PLAYER Waiver and Registration Form

* Completion of this form does not include any dues or fees.
**ALL new and returning players must complete this form prior to practicing.

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Full Name (Last, First)
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Date of Birth
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Current Address (Street, City, Zip)
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Primary Phone (###-###-####)
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Current Employer
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Emergency Contact Name
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Emergency Contact Number (###-###-####)
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Emergency Contact Relationship
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Agreement and Waiver
- The Washington Renegades Rugby Football Club, Inc. (WRRFC; the "Renegades") is a non-profit corporation in the District of Columbia. The Renegades' mission is to learn, teach, and play rugby; to forge new friendships; to celebrate others' differences; and to give back to its supportive communities through charitable and educational activities. By joining the WRRFC, and by participating in events sponsored by the Renegades, I indicate my acceptance of and agreement with the club's mission. - I represent and warrant that I - a prospective or current member of USA Rugby - agree to abide by and be bound by the applicable Bylaws, disciplinary regulations, rules, regulations, Code of Conduct, and competition rules of USA Rugby, as well as the safe sport rules, policies, and procedures promulgated by the U.S. Center for Safe Sport, as they may be amended from time to time. - I understand that rugby carries with it the risk of injury. I agree to assume all the risks inherent in playing the sport, and agree to indemnify and hold harmless WRRFC in the event I suffer injury of any kind while playing rugby or participating in the club's events. I understand that WRRFC strongly encourages that members who practice and/or play with the team have adequate medical insurance but leaves the decision on the type and nature of insurance to the members. I also understand USA Rugby requires adequate medical insurance in order to play in officially-sanctioned rugby games and tournaments. - I understand that the participation of active members is essential to enabling WRRFC to transact its business at meetings of the members. If I become inactive (as defined by the Board of Directors) for a period of three or more months, I agree that the Board - at its discretion - may upon adequate notice judge me to be an inactive member for purposes of establishing a quorum at any meeting of the members. If that occurs, I reserve the right to re-activate my membership, conditioned upon my being in good standing and current with all dues and debts to WRRFC for the fiscal year, by sending written notice to the Secretary. I understand that my dues are non-refundable should I choose to leave the club.
SIGNATURE - by entering my full name I offer my formal acceptance of these terms and attest that the information provided is true and accurate to the best of my knowledge.
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