Rugby Academy America - Furman Camp Registration

Rugby Academy of America

2018 Las Vegas Invitational

Registration open till January 31, 2018!

*Limited spaces left!

RAA Select-Side Touring Team includes the following:

Tourney Entry Fee
Dedicated Tour Director
Intensive Tour Camp
Team Swag
Room & Board
Team CiPP
Athletic Trainer
Team kit available for purchase

Location: Las Vegas, NV

Dates: Sunday, February 25, 2018 thru Sunday, March 4, 2018

Duration: Check-in to team housing will be open starting at 2pm on the 25th and Checkout will be by 12pm on the 4th

Teams:

RAA Women's Elite

RAA High School Boys (U19)

RAA Men's America's Cup (Elite)

Register at the following link: https://www.rugbyacademyamerica.com/

Registration: Registration is now open and will close on January 15th

Accommodations: Team housing will be provided, transportation, breakfast, dinners, and team water provided.

Transportation: Transportation to and from the airport will be provided by van. Transportation to and from practices and games will also be provided.

Costs:

$599

Who's Eligible to Participate:

Any age appropriate athlete who completes the 8-Week RAA Daily Training Envirenment. The RAA DTE is a weekly virtual training environment which includes Strength and Conditioning training, Speed/Agility/Quickness training, Injury Prevention/Recovery methodology, and Skill Developement and Tactical Awareness through video analysis.

For any questions, please contact us at coaches@rugbyacademyamerica.com

Athlete Name:*

First NameLast Name

Athlete Email

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Athlete Phone

Area CodePhone Number

T-Shirt Size*

Gender*

Athlete Home Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Birth Date*

Date

Weight in Lbs*

Height (example 5 feet 8 inches would be 5' 8")*

Rugby Club Name*

Health Insurance Company*

Health Insurance Policy #*

Is the Athlete prescribed any medication? If yes, please explain any instructions. *

Does the Athlete have any allergies, chronic illness or medical conditions? If yes, please describe.*

Name*

First NameLast Name

Relationship*

Phone Number*

Area CodePhone Number

USA Rugby Membership

I hereby confirm that I am an active member of USA Rugby’s Club and Individual Participation Program (CIPP).

If you are currently not a USA Rugby CIPP member, you can register at https://webpoint.usarugby.org/wp/Memberships/Join.wp

USA Rugby Membership Acknowledgement*

Informed Consent and Acknowledgement

I hereby give my approval for my child's participation in any and all activities with Rugby Academy of America (RAA) . In exchange for the acceptance of said child's candidacy by Rugby Academy America, I assume all risk and hazards incidental to the conduct of the activities, and release, absolve and hold harmless Rugby Academy America and all its respective officers, agents, and representatives from any and all liability for injuries to said child arising out of traveling to, participating in, or returning from Rugby Academy America trainings, camps and events.

In case of injury to said child, I hereby waive all claims against Rugby Academy America, including all coaches and affiliates, all participants, sponsoring agencies, advertisers, and, if applicable, owners and lessors of premises used to conduct the event. There is a risk of being injured that is inherent in all sports activities, including rugby. Some of these injuries include, but are not limited to, the risk of fractures, paralysis, or death.

Informed Consent and Acknowledgement*

Medical Release and Authorization

As Parent and/or Guardian of the named athlete, I hereby authorize the diagnosis and treatment by a qualified and licensed medical professional, of the minor child, in the event of a medical emergency, which in the opinion of the attending medical professional, requires immediate attention to prevent further endangerment of the minor's life, physical disfigurement, physical impairment, or other undue pain, suffering or discomfort, if delayed.

Permission is hereby granted to the attending physician to proceed with any medical or minor surgical treatment, x-ray examination and immunizations for the named athlete. In the event of an emergency arising out of serious illness, the need for major surgery, or significant accidental injury, I understand that every attempt will be made by Rugby Academy of America staff to contact me in the most expeditious way possible. This authorization is granted only after a reasonable effort has been made to reach me.

Permission is also granted to the Rugby Academy of America and its affiliates including Coaches, and Trainer to provide the needed emergency treatment prior to the child's admission to the medical facility.

Release authorized on the dates and/or duration of all Rugby Academy of America events

This release is authorized and executed of my own free will, with the sole purpose of authorizing medical treatment under emergency circumstances, for the protection of life and limb of the named minor child, in my absence.

Medical Release and Authorization*

Code of Conduct

As a participant of an Rugby Academy of America (RAA) event, camp or tour I promise that I will:

Show good character and values. Be honest, trustworthy, and responsible.
Respect myself, teammates, coaches, officials, opponents and the game.
Follow team/academy rules at all times.
Give my best effort at all times.
Declare the use of any and all medications. and NOT use tobacco, alcohol, illegal drugs, or banned performance enhancing substances.
Not engage in any criminal conduct, including, but not limited to laws governing the possession, provision and use of drugs, and or alcohol.

Violations of the code WILL result in one or more of the following:

a) Dismissal from the event and sent home immediately (additional travel costs will be the responsibility of the player and his family).

b) Suspension - from RAA event, ranging from training sessions to game suspension to more where a player will not compete for a specified period of time or number of games. This can include a suspension of CIPP.

c) Community Service. The player will complete a determined number of hours in a recommended community service project after the event if they are to return in good standing to RAA.

By signing I pledge to uphold the spirit of this Code which offers a general guide to my behavior and conduct. I acknowledge that I have a right to a hearing if my opportunity to compete is denied for any reason or if I'm charged with any violation of the Code. That hearing will be within 24 hours of any alleged violations. The hearing committee will include the Head Coach, assistant coach and or Team Manager. The decision of the committee will be final.

Code of Conduct*

Media Release

I grant designated RAA staff permission to use photograph(s) or video of myself for purposes of publicity or advertising on platforms such as website, Facebook, advertisements, social media, or brochures.

Media Release*

Confirmation

BY ACKNOWLEDGING AND SIGNING, I AM DELIVERING AN ELECTRONIC SIGNATURE THAT WILL HAVE THE SAME EFFECT AS AN ORIGINAL MANUAL PAPER SIGNATURE. THE ELECTRONIC SIGNATURE WILL BE EQUALLY AS BINDING AS AN ORIGINAL MANUAL PAPER SIGNATURE

My Products

2018 Las Vegas Inventational Fee$599.00

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