Houston SaberCats
Rugby Academy

  1. YesNo
  2. If yes, please explain any instructions.
  3. Does the athlete have any allergies, chronic illness, or medical conditions?
  4. If yes, please describe.
  5. What is your first choice for playing position?
    PropHookerLockFlankerScrum HalfCenterWingFull Back
  6. What is your second choice for playing position?
    PropHookerLockFlankerScrum HalfCenterWingFull Back

  7. Informed Consent and Acknowledgement
    I def give my approval for my son's participation in any and all activities with Sabercat's Rugby Academy . In exchange for the acceptance of said child’s candidacy by Sabercat's Rugby Academy, I assume all risk and hazards incidental to the conduct of the activities, and release, absolve and hold harmless Sabercat's Rugby Academy 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 Sabercat's Rugby Academy trainings and events.

    In case of injury to said child, I hereby waive all claims against Sabercat's Rugby Cobine. 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 (Parent or Guardian or Player if 18 at time of acknowledgement) * I ConsentI Do Not Consent

  8. 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 Sabercat's Rugby 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 Sabercats 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 Sabercats Rugby 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 Consent (Parent or Guardian or player if 18 at time of acknowledgement)* I ConsentI Do Not Consent

  9. Code of Conduct
    As a participant of a Sabercat's Rugby Academy, Combine, 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 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.

    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.

    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 Consent * I ConsentI Do Not Consent

  10. Media Release
    I grant designated Sabercat's Rugby Staff permission to use photograph(s) or video of my child for purposes of publicity or advertising on platforms such as website, Facebook, advertisements, social media, or brochures. By electing to have your child be part of an Sabercat's Rugby sponsored event you are aware that your child’s likeness may be used and that their name may also be used. Sabercat's Rugby elects to use the full name of your child in order to identify them for possible scouting or selection to representative sides such as the High School All Americans.
    If the parent or guardian requests that their player’s likeness not be used then they need to notify Sabercat's Rugby prior to any event.

    A parent signature confirms permission to use your son's photo image
    Media Release Consent * I ConsentI Do Not Consent

  11. Anything else we should know? Leave us a note.