Insurance Acknowledgment - Returning Participant yet to register

This form is for players returning to rugby league in the 2025 season who have not yet registered.  It applies to players who are both new to the club and returning.   

By submitting this form, you confirm your acknowledgment and agreement to the following terms, including the collection and use of the information provided.  If completing this form as a parent or guardian of a participant under 18, you do so on their behalf.

Obligations to Train

1. The player (or in the case of a player under 18, their parent or guardian) agrees to complete this form prior to attending their first training session. 

2. The player (and/or in the case of a player under 18, their parent or guardian) agrees to observe and be subject to all the rules, regulations, by-laws and directions published by the club and QRL in addition to obeying all reasonable directions of the club relating to training for the game of Rugby League.

3. The club and the player (and/or in the case of a player under 18, their parent or guardian) agree to the terms outlined herein for the period of fourteen (14) days from the participants' first training session.   

4. Both parties agree that each is released from all obligations, rights, and responsibilities under this Agreement.  

Insurance Waiver Acknowledgement
The participant (and/or in the case of a player under 18, their parent or guardian) agrees to indemnify and hold harmless the Queensland Rugby League and Currumbin Eagles from and against any and all claims, damages, liabilities, costs, and expenses, including but not limited to legal fees, arising out of or resulting from any injury, accident, or harm sustained by the participant.

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Email *
Participant full name *
Address *
Is the participant under 18? *
If under 18, please provide parent / guardian full name
Participant date of birth *
MM
/
DD
/
YYYY
Phone number (please provide parent / guardian number if under 18) *
Team *
I understand that the participant is not covered for any accident/​injury sustained during their Come and Try Agreement period.
 *
Required
I understand that in order for the participant to be insured for accident/​injury, I would need to register them and pay the non-refundable insurance premium.
 *
Required
Please type your full name (in place of a signature).  A participant under 18 cannot sign this acknowledgement.  *
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