1. I understand dangers may be caused by my own actions, or inaction, the actions or inactions of others participating in an event sanctioned by the FORT WAYNE RUGBY FOOTBALL CLUB, (FWRFC), here forth known collectively as "the Club". I understand the nature of Club events and acknowledge my experience and capabilities and believe I am qualified and trained to participate in such Club events.

2. I further acknowledge that I am aware that the activity will be conducted in facilities open to the public during such events.

3. I further agree and warrant that if, at any time, I believe conditions to be unsafe, I will immediately discontinue further participation in the event.

4. I fully understand that: (a) Club events involve risks and dangers of serious bodily injury, including permanent disability, paralysis, and death, (“Risks”); (b) these Risks may be present in the event or due to the negligence of the releases named below; (c) there may be other risks and social and economic losses either not known to me or not readily foreseeable at this time; and I FULLY ACCEPT AND ASSUME ALL SUCH RISKS AND ALL RESPONSIBILITY FOR LOSSES, COSTS, AND DAMAGES incurred as a result of my participation in the event.

5. I further acknowledge that the COVID-19 Pandemic is a significant public health issue, which requires strict adherence to mitigation and reporting policies and procedures. The Club has developed such policies and procedures in conjunction with USA Rugby, and in accordance with CDC Guidelines, which allows for a Return To Play (“RTP”), and a Return To Competition (“RTC”). Additionally, all Midwest Rugby Football Union (MWRFU) Member Clubs have adopted these procedures and implemented them to the fullest extent required by local health departments, State Health Departments, and the MWRFU.

6. I attest to the fact that I have completed all RTP and RTC reporting mechanisms required by the Club and the MWRFU.

7. I attest that I do not have symptoms of COVID-19 and I have no knowledge that I have, nor any reason to believe that I may have contracted COVID-19.

8. I hereby release, discharge, covenant not to sue and agree to hold harmless the Club and participating, their respective administrators, directors, agents, officers, volunteers, and employees, other participants, any sponsors, advertisers, and if applicable, owners and lessors of premises on which the event takes place (each considered one of the “Releases” herein) from all liability, claims, demands, losses, or damages on account caused or alleged to be caused in whole or in part by the negligence of the “Releases” or otherwise, including negligent rescue operations and further agree that if, despite this release, I, or anyone on my behalf makes a claim against any of the Releases named above, I WILL INDEMNIFY, SAVE AND HOLD HARMLESS EACH OF THE RELEASEES FROM ANY LITIGATION EXPENSES, ATTORNEY FEES, LOSS LIABILITY, DAMAGE OR COST ANY MAY INCUR AS THE RESULT OF ANY SUCH CLAIM.

9. I AFFIRM THAT I HAVE A PERSONAL MEDICAL INSURANCE POLICY. I understand that any lapse in policy or event that would cause my personal medical insurance policy to not be in good standing and/or able to participate in Club events, I am ineligible to play and that I have an affirmative responsibility to withdraw from competition.

10. Representations. I represent that: (i) I am 18 years old or older; (ii) I know of no reason, medical or otherwise, which would prevent me from participating in any Club events; (iii) I understand and agree that this Release is binding upon me, and my heirs and assigns; and (iv) I represent that I have full legal authority to do so and realize the binding effect of this Release on the Club, participating member clubs, as well as on myself.

NOTICE, WAIVER, RELEASE OF LIABILITY AND ASSUMPTION OF RISK
I HAVE READ THIS AGREEMENT, FULLY UNDERSTAND ITS TERMS, UNDERSTAND THAT I HAVE GIVEN UP SUBSTANTIAL RIGHTS BY SIGNING IT AND HAVE SIGNED IT FREELY AND WITHOUT INDUCEMENT OR ASSURANCE OF ANY NATURE AND INTEND IT TO BE A COMPLETE AND UNCONDITIONAL RELEASE OF ALL LIABILITY TO THE GREATEST EXTENT ALLOWED BY THE LAW AND AGREE THAT IF ANY PORTION OF THIS AGREEMENT IS HELD TO BE INVALID THAT THE BALANCE, NOTWITHSTANDING, SHALL CONTINUE IN FULL FORCE AND EFFECT.