School Rugby Tour
Medical & Liability Waiver
Participant Information
Full Name
Date of Birth
School
Parent/Guardian Name
Contact Number
Email
Medical Information
Allergies or Medical Conditions
Current Medications
Health Insurance Provider
Policy Number
Emergency Contact Name
Emergency Contact Number
Medical Consent
By signing below, I authorize the school staff/chaperones to obtain emergency medical care for my child if necessary during the Rugby Tour, and I accept responsibility for any medical expenses incurred.
Liability Waiver
I, the undersigned, understand that participation in the Rugby Tour involves physical activities and the risk of injury. I hereby release the school, staff, and associated parties from liability for accident, injury, or loss during the event, except in case of gross negligence.
Signatures
Parent/Guardian Signature
Date
Participant Signature (if over 18)
Date