STARTS NOW!!!!!!!!
To complete your registration please fill out the forms below and mail to me at the following address:
Coach Hughes
22256 Lantern Lane
Lake Forest, Ca. 92630
1. Consent form (below)
2. Information Sheet (below)
3. Dues and Merchandise Order (below)
4. Dues paid to ($250.00)
South Orange County Gators
5. Copy of Birth Certificate with School
ID or Driver Lisence
6. A digital photo of just the players
head with a white background with
no glasses or hats on. Send it to
hughesfam2@cox.net
SOUTH ORANGE COUNTY RUGBY FOOTBALL CLUB
INFORMED CONSENT AWARENESS OF SPORTS INJURY RISK
WARNING AND AGREEMENT
By its very nature, competitive athletics can put youths in situations in which SERIOUS, CATASTROPHIC, and perhaps FATAL accidents could occur.
Youths and parents/guardian must assess the risks involved in such participation and make their choice to participate in spite of those risks. No amount of instruction, precaution, or supervision will totally eliminate all risk of injury. Just as driving an automobile involves choice of risk; participation in athletics is inherently dangerous. The obligation of parents and youths in making this choice to participate cannot be over-stated.
By granting permission to your son/daughter to participate in a rugby league competition, a parent or guardian acknowledges that playing or practicing in this sport can be a dangerous activity involving MANY RISKS OF INJURY. Both the youth and parent must understand that the dangers and risks of playing or practicing to play include but are not limited to, death, complete or partial paralysis, brain damage, serious injury to virtually all internal organs, bones, joints, ligaments muscles, tendons and other aspects of the skeletal system and potential impairment to other aspects of the body, general health and well being.
Because of the dangers of participation in rugby, we (parent and youth) recognize the importance of following coaches’ instructions regarding playing techniques, training, equipment and other team rules, etc. both in competition and practice and agree to obey such instructions.
If any of the foregoing is not completely understood and you have questions, please contact your coach for further information.
At the beginning of the club season of practice both the youth and parent need to be informed in writing of the above information. The club must require that both the youth and the parent sign and date this sheet of paper acknowledging that they have read the above statement and understand it thoroughly. This paper with signatures will be kept on file with the coach.
I have read and understand the information above and give my son/daughter permission to participate in rugby.
Son/Daughter Name ___________________________________________________
Parent/Legal Guardian Signature _________________________ Date______________
I have read and understand the information above.
Youth Signature _________________________ Date ________________
INFORMATION SHEET
Player Name: __________________________________________
Grade: _________
School: ___________________
Home Address: __________________________________________
City: _________________________
Zip Code: ___________
Home Phone: ____________________________________________
Cell Phone (Parents): __________________________________
(Player): ___________________________________
Email: _________________________________________________
Guardians Name: _________________________________________
Players Height: _________________ Weight: __________
Birthday: _____________________________
Medical Insurance: _____________________________________
Policy Number: _________________________________________
Any Medical Notes coach needs to know about:
DUES AND MERCHANDISE LIST
Dues
Dues to be registered to So. Cal. Rugby
Jersey useage
Practice and Game rugby balls
Referee Fees
Field Costs
Lights for practices
Food/Water for home games for us and opponent
Total dues for the season are $250.00 payable to "South Orange County Gators"
Merchandise (optional)
$10 Socks (Black)
$30 Size _____ Shorts (Black)-
$45 Size ______Practice Jersey (Black with
GATORS RUGBY on back)
$15 Size _____T- shirt (Black with GATORS RUGBY
on the front and LOGO on the back)
$30 Size _____Hooded Sweat Shirt (same as T-
shirt)
$30 Size _____Crew Sweat Shirt (same as T-shirt)
$20 Rugby Ball ( LOGO and Website on panels)
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