EXILES RFC

Alpharetta Exiles Rugby Football Alumni Association CO dba Exiles Rugby Club A Georgia 501(c3) Nonprofit Organization | EIN:88-3621299 www.exilesrugby.org | Alpharetta, Georgia

This is a legal document. Please read carefully before signing.

YOUTH RUGBY PARTICIPATION WAIVER AND RELEASE OF LIABILITY - STATE OF GEORGIA

In consideration of the Participant being allowed to participate in any way in activities, training, clinics, practices, scrimmages, travel, conditioning, matches, or events ("Activities") organized, hosted, or operated by Alpharetta Exiles Rugby Football Alumni Association CO, dba Exiles Rugby Club ("Exiles Rugby Club," "the Club"), the undersigned agrees as follows:

1. Assumption of Risk I understand and acknowledge that participation in rugby involves inherent risks, hazards, and dangers that cannot be completely eliminated, including but not limited to: physical contact, tackling, collisions, scrums, rucks, mauls, falling, impacts with playing surfaces and equipment, dehydration, heat-related illness, sprains, fractures, concussions, spinal injuries, paralysis, and in rare cases, death. I voluntarily assume all risks, known and

unknown, associated with my child's participation. I accept full responsibility for my child's decision to participate. Parent/Guardian Initials:

2. Acknowledgement of Rugby-Specific Risks I understand rugby is a full-contact sport governed by World Rugby Laws of the Game. Despite safety rules and coaching, injuries may occur. Risk of concussion and orthopedic injury is significant. Participation includes travel to and from venues and facilities, and these risks extend to transportation and off-field Club activities. I certify my child is physically and mentally fit to safely participate. Parent/Guardian Initials:

3. Medical Authorization and Duty to Disclose I certify that I have disclosed all relevant medical, behavioral, or physical conditions that may affect participation. I authorize the Club, its coaches, volunteers, or designated medical personnel to secure emergency medical care, including hospitalization, surgery, anesthesia, injections, medication, or other treatment deemed necessary. I understand I am solely responsible for all related medical costs. The Club does not provide medical insurance.

Medical Conditions/Allergies (Required): Medications (Required):

Emergency Contact Name: Secondary Contact Name:

4. Insurance Responsibility I acknowledge and agree that Exiles Rugby Club does not provide primary medical insurance coverage for participants. I represent that my child is covered by a valid and active medical insurance policy. I agree to be fully responsible for any medical, dental, hospital, or related expenses arising from participation. I agree not to seek compensation or reimbursement from the Club.

Insurance Provider (Required):

5. Release of Liability and Waiver of Claims To the fullest extent permitted by Georgia law, I, on behalf of myself, the Participant, and our heirs and assigns, hereby release, waive, and discharge Exiles Rugby Club, its Board of Directors, officers, coaches, team managers, volunteers, agents, affiliates, sponsors, field partners, and any persons acting on its behalf from any and all liability, claims, demands, or causes of action arising out of or related to any loss, damage, injury, or death that may be sustained, whether caused by negligence (ordinary) or otherwise, during participation in Club Activities. This waiver does not apply in cases of gross negligence or willful misconduct under Georgia law. Parent/Guardian Initials:

I agree to indemnify and hold harmless Exiles Rugby Club and its representatives from any loss, liability, damage, or cost, including attorney's fees, arising from my child's participation, including claims brought by third parties, other participants, facilities, or medical providers. I agree this indemnification survives the expiration or termination of this agreement. Parent/Guardian Initials:

8. Concussion Risk, Protocol, and Removal from Play I understand the risk of concussion and traumatic brain injury in youth contact sports. I acknowledge that Exiles Rugby Club follows a "Recognize and Remove" policy consistent with World Rugby and Georgia Code O.C.G.A. § 20-2-324.1. I agree that any player suspected of concussion will be immediately removed from play and may not return without written clearance from a licensed medical professional. I agree to report all concussion symptoms honestly. Parent/Guardian Initials:

9. Compliance with Club Policies I agree to follow all Club policies, safety rules, and behavior expectations. I understand violations may result in suspension or removal from the Club without refund. I understand this waiver incorporates by reference Club policy documents, including but not limited to: Exhibit A - Player Code of Conduct, Exhibit B - Parent/Spectator Policy, Exhibit C - Anti-Bullying Policy, Exhibit D - Refund Policy. Parent/Guardian Initials:

10. Photo, Video, and Media Release (Optional) I grant permission for my child to appear in team photographs, video, and promotional materials related to the Club. I understand this may include social media, websites, broadcasts, or print. I waive any right to compensation or approval. (If you do not consent, check below and initial

I DO NOT consent to media use of my child. Initial here to decline: 11. Transportation Release I understand that transportation to and from rugby events is my responsibility unless otherwise arranged. I acknowledge and accept all risks related to travel to Club activities, including carpools, vans, buses, or volunteer transportation. Parent/Guardian Initials:

12. Binding Arbitration and Venue I agree that any dispute arising from this agreement or participation in Club Activities shall be resolved by binding arbitration in Fulton County, Georgia, under the rules of the American Arbitration Association. I waive my right to a jury trial. Venue for any legal action shall be exclusively in Fulton County, Georgia. Parent/Guardian Initials:

13. Severability and Survival If any portion of this agreement is found unenforceable, all remaining provisions shall remain in full force. All waivers, indemnifications, and risk assumptions survive participation. Parent/Guardian Initials:

14. Acknowledgment of Understanding I have carefully read this document. I understand it is a legal agreement that limits my rights, and I sign it voluntarily. I understand that by signing, I am giving up substantial rights, including the right to sue for ordinary negligence. I certify that I am the parent/legal guardian of the Participant and legally authorized to sign.

Parent/Guardian 1 Name (Print): Signature:

Parent/Guardian 2 Name (Optional): Signature (Optional):

Participant Signature (Required if age 13-17): Date:

Alpharetta Exiles Rugby Club Use Only Received by:

Alpharetta Exiles Rugby Football Alumni Association CO, dba Exiles Rugby Club - Georgia 501(c3) Nonprofit | EIN 88-3621299