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* 1. Please enter first and last name of participant

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* 2. Please enter age of participant

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* 5. Please enter name of Parent/Guardian

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* 6. Please enter best contact email

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* 8. Terms and Conditions 

USE OF IMAGE:
I hereby grant BC Rugby and Rugby Canada the irrevocable right to use, at their sole discretion any information and/or photographs of or about myself for any publicity, advertising or other promotion of BC Rugby or Rugby Canada in any and all media without compensation or further notification. I understand that this may include written, pictorial, or video materials.


USE OF IMAGE: I hereby grant my club and associated provincial/territorial and national governing bodies, including Rugby Canada and Rugby Canada’s sponsors, the irrevocable right to use, at their sole discretion any information and/or photographs of or about myself or my child, as applicable, including without limitation, my (or my child’s) name, address, voice, photograph, image and/or other likeness, for publicity, advertising or other promotion of my club and/or associated provincial/territorial and/or national governing body in any and all media without compensation or further notification. I understand that this may include written, pictorial, or video materials.

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