Step 1 Team Contact Information: Complete online form with general club and contact information.

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1 2015 USA Rugby Fall College Playoffs Founders Field Pittsburgh, PA November 21 st & 22 nd 2015 VENUE Founders Field 101 Eisele Road Pittsburgh, PA CONTACTS USA Rugby On-Site: Rich Cortez, , USA Rugby Eligibility: Nicholas Bridenbaugh, , USA Rugby Media: Alex Solomon, , USA Rugby Competitions: James Wilber, , Host Contact: Matt Rosemeyer, , LODGING Hamption Inn-Monroeville 3000 Mosside Blvd. Monroeville, PA Please call by November 13 to make reservations Reference Block Code Pitt Harlequins Reservation Link: PIT /index.jhtml?WT.mc_id=POG Red Roof PLUS+ Pittsburgh East Monroeville 2729 Mosside Blvd. Monroeville, PA Block Code B174HARLEQ ELIGIBILITY Please Contact Nicholas Bridenbaugh at USA Rugby if you need to file an eligibility waiver request or have a question about the eligibility regulations. Step 1 Team Contact Information: Complete online form with general club and contact information. Step 2 Team Participation Agreement (Attached): This form must be signed and dated by your team representative, as well as an Athletics, Club/Recreational Sports, or Student Services Department representative. This affirms that you understand what is required of you and your team at a USA Rugby National Championship Event. Completed forms should be forwarded to jwilber@usarugby.org. Step 3 *Be sure to include all eligibility waivers granted to players traveling to this event Collegiate Player Eligibility Form: To be completed prior to the start of league competition and competition in USA Rugby College Playoffs and Championship Events.

2 2015 USA Rugby Fall College Playoffs Founders Field Pittsburgh, PA November 21 st & 22 nd 2015 Collegiate Player Eligibility Form Grandfather Clause: To be completed prior to league competition and competition in USA Rugby College Playoffs and Championship Events, specifically for players who are not eligible under the standard regulations but who are eligible under the grandfather clause of those regulations. Completed forms should be forwarded along with those referenced in Step 2 to jwilber@usarugby.org. Step 4 Participation Waiver (Required of all participants): The participation waiver is no longer separated into adult and minor forms, but combined in a single document. A complete copy of this form need be presented by all players at check-in. Should a minor player have completed a waiver for participation in college rugby, please ensure that the athlete s parent/guardian provides the appropriate signatures on the participation waiver and that the completed U18 Participation in College Rugby Waiver is present at check-in. Step 5 Event Media Release Agreement (Attached): This form must be signed and dated by all members of your tour party. All members are to sign and date the form. If a player is under the age of 18, the player and his/her parent or legal guardian must complete the form and also complete the final page of the document. Please use the attached Championship Checklist to confirm achievement of all five steps. Championship paperwork may be returned to jwilber@usarugby.org. TRAINING SCHEDULE Advance training time may be requested online. Please use this electronic form to secure a training timeslot. TEAM CHECK-IN Friday, November 20 th If there is a problem with your team s scheduled check in time, please contact James Wilber (jwilber@usarugby.org) to re-arrange as soon as possible. Your team must be fully checked in at least 1 hour prior to your kick off. All participants must be checked in. Team Check-In Times at Founders Field Clubhouse 5:00-5:15: Coast Guard 5:15-5:30: IUP Women 5:30-5:45: Davenport 5:45-6:00: Kent State 6:00-6:15: Towson 6:15-6:30: SUNY Oswego 6:30-6:45: Rowan & Notre Dame 6:45-7:00: Eastern Kentucky 7:00-7:15: Cincinnati 7:15-7:30: Princeton 7:30-7:45: U Connecticut 7:45-8:00: UW Whitewater & UMass Lowell 8:00-8:15: Springfield 8:15-8:30: Rhode Island 8:30-9:00: Meeting

3 2015 USA Rugby Fall College Playoffs Founders Field Pittsburgh, PA November 21 st & 22 nd 2015 COACHES/CAPTAINS MEETING: 8:30PM Friday, November 20 th at Founders Field Clubhouse You must have at least one representative from your team at this meeting! This is your opportunity to ask any and all questions about the event, as well as to be notified of any last minute changes. VISITOR INFORMATION PARKING: There will be a $10.00 parking fee per vehicle, with all proceeds benefitting the Pittsburgh Harlequins Children s Charities. Each team will be provided with two parking permits. CONCESSIONS are available at the facility at reasonable rates. TOURNAMENT T-SHIRTS are available at a 10% discount when ordered in one advance, fullteam order. Please contact Matt (matt@pittsburghharlequins.org) with Adult Sizes and Quantities for pickup at the event. Bulk orders intended for resale may be sought through the same address. Please inquire as soon as possible. Tournament t-shirts will otherwise be on sale at the event venue for $ MATCH SCHEDULE Match Day Time Field Division Team 1 Team 2 1 Saturday 9:00 AM 1 WDII Eastern Kentucky Davenport 2 Saturday 9:00 AM 2 WDII Cincinnati Indiana U. of PA 3 Saturday 11:00 AM 1 WDI Univ. Notre Dame Princeton 4 Saturday 11:00 AM 2 WDI Kent State Connecticut 5 Saturday 1:00 PM 1 MDII A SUNY Oswego Univ. Rhode Island 6 Saturday 1:00 PM 2 MDII A UW Whitewater Springfield 7 Saturday 3:00 PM 1 MDII B UMass Lowell Rowan 8 Saturday 3:00 PM 2 MDII B Towson U.S. Coast Guard 9 Sunday 8:30 AM 1 WDI Consolation L Match 3 L Match 4 10 Sunday 8:30 AM 2 WDII Consolation L Match 1 L Match 2 11 Sunday 10:30 AM 1 WDI Qualifier W Match 3 W Match 4 12 Sunday 10:30 AM 2 WDII Victlors W Match 1 W Match 2 13 Sunday 12:30 AM 1 MDII A Victors W Match 5* W Match 6* 14 Sunday 12:30 AM 2 MDII A Consolation L Match 7 L Match 8 15 Sunday 2:30 PM 1 MDII B Victors W Match 7 W Match 8 16 Sunday 2:30 PM 2 MDII B Consolation L Match 5* L Match 6* **Matches 14 and 16 may switch, please check with Rich Cortez at end of Day 1

4 2015 USA Rugby Fall College Playoffs Founders Field Pittsburgh, PA November 21 st & 22 nd USA Rugby Fall College Playoffs Championship paperwork may be returned to Form Due Date Format Complete 1. Team Contact Information Form Monday, November 16 Online Team Contact Information 2. Team Participation Agreement Monday, November 16 Must include signature of university representative 3. Collegiate Player Eligibility Form Monday, November 16 Collegiate Player Eligibility Form Must include signature of university representative 4. Individual Participation Waivers Check-in Paper Participation Waiver (Required of all participants) Fri November 20th Minor Players will require parent/guardian signatures on the participation waiver, AND a completed U18 Participation in College Rugby Waiver present at check-in 5. Event Media Release Agreement Check-in Paper Must include all sideline staff signatures Fri November 20th Must include a complete minor media waiver form for all minor participants Documents in your Folder (received at meeting): USA Rugby Code of Conduct USA Rugby Inclement Weather Policy USA Rugby Overtime Policy USA Rugby Technical Zone & Sideline Management Guidelines USA Rugby Tournament Information Packet

5 Formal Acceptance of the Team As conditions for participation in the USA RUGBY Playoffs and Championships we affirm that: 1. The Team noted below accepts the responsibility for participation in the USA RUGBY Playoffs and Championships in accordance with the rules, regulations, and guidelines of USA Rugby. 2. The Team will make its best efforts to arrive at the tournament site no later than the USA Rugby designated check in time posted to the USA Rugby web site. a. In the event that unavoidable circumstances prevent the team from timely arrival, the team will notify the USA Rugby designated person (see Tournament Information Packet at as soon as possible. 3. The Team representative will participate in all meetings and functions as designated by USA Rugby to include the Captain s/manager s Meeting. a. In the event that unavoidable circumstances prevent the team from attending such a meeting a team representative will notify the USA Rugby designated person (see Tournament Information Packet at as soon as possible. 4. The Team will participate in all assigned matches, and be at the pitch prepared to play no later than 15 minutes prior to kick off. 5. The Team accepts responsibility for ensuring all team members are in like uniforms, i.e. matching socks, shorts, jerseys numbered 1-23 with players wearing numbers appropriate to the position played, to include the wear of IRB approved protective garments and boots. 6. The College Team uniforms will be free of any and all tobacco or alcohol sponsors, and/ or other categories as reasonably specified by USA RUGBY. 7. By virtue of its acceptance of the opportunity to play in this championship, the Team, and any and all clubs with which it is affiliated, affirm that all team members are CIPP registered, and have, through the execution of a CIPP registration form, confirmed that they will have a minimum of $100,000 in medical coverage throughout the USA RUGBY season, including this tournament, and that any member who does not have such coverage has an affirmative responsibility to withdraw from play. Team Rep Initial College/University Rep Initial Conference Rep Initial

6 8. The Team accepts responsibility for ensuring that all team members are eligible to participate in the USA RUGBY Playoffs and Championships in accordance with USA Rugby s Eligibility Guidelines. a. The Team accepts responsibility for ensuring o the best of their ability that all team members have accurately represented their enrollment information and eligibility status to USA RUGBY and have the appropriate documentation to verify such status. b. All team members have been informed that any member who does not meet the USA Rugby requirements for enrollment and eligibility has an affirmative responsibility to withdraw from play. 9. The Team accepts responsibility for informing all team members and coaching staff of their responsibility to display sportsman-like conduct and appropriate behavior on or off the field. 10. The Team agrees that this agreement shall be governed by and construed in accordance with the rules, regulations and guidelines of USA Rugby. 11. The Team accepts that the failure of any player to honor this agreement may place the player(s) and/or their team, Conference, and/or Union in jeopardy of sanctions and disciplinary proceedings, including, but not limited to the potential for disqualification from this event, fines to players, clubs or teams, and/or loss of a seed in future USA Rugby sanctioned events. Team Representative Name (Print): Team: Signature of Representative: Date: *Please include initials at bottom of Page 1 Conference Rep Name (Print): Conference Rep Title: Signature of Representative: Date: *Please include initials at bottom of Page 1 College/University Rep Name (Print): College/University Rep Title (Print): Signature of Representative: Date: Team Rep Initial *Please include initials at bottom of Page 1 College/University Rep Initial Conference Rep Initial

7 Event Media Release Agreement We hereby authorize and give our full consent to USA RUGBY to copyright and/or publish any and all photographs, videotapes, film, web casts/podcasts, and any other form of visual/audio communications in which we appear (separately or together) while attending any USA Rugby Championships event. We further agree that USA Rugby may transfer, use or cause to be used, these above mentioned communications for any exhibitions, public displays, publications, commercials, art and advertising purposes, and television programs without limitations or reservations. Signature Printed Name Date **NOTE: All players under the age of 18 MUST fill out the form signifying parental permission on the final page of this document. If a parent/guardian signature is missing prior to the event the under-18 player will not be allowed to participate.

8 Event Media Release Agreement We hereby authorize and give our full consent to USA RUGBY to copyright and/or publish any and all photographs, videotapes, film, web casts/podcasts, and any other form of visual/audio communications in which we appear (separately or together) while attending any USA Rugby Championships event. We further agree that USA Rugby may transfer, use or cause to be used, these above mentioned communications for any exhibitions, public displays, publications, commercials, art and advertising purposes, and television programs without limitations or reservations. Signature Printed Name Date **NOTE: All players under the age of 18 MUST fill out the form signifying parental permission on the final page of this document. If a parent/guardian signature is missing prior to the event the under-18 player will not be allowed to participate.

9 Event Media Release Agreement We hereby authorize and give our full consent to USA RUGBY to copyright and/or publish any and all photographs, videotapes, film, web casts/podcasts, and any other form of visual/audio communications in which we appear (separately or together) while attending any USA Rugby Championships event. We further agree that USA Rugby may transfer, use or cause to be used, these above mentioned communications for any exhibitions, public displays, publications, commercials, art and advertising purposes, and television programs without limitations or reservations. Signature Printed Name Date **NOTE: All players under the age of 18 MUST fill out the form signifying parental permission on the final page of this document. If a parent/guardian signature is missing prior to the event the under-18 player will not be allowed to participate.

10 2015 USA RUGBY NATIONAL CHAMPIONSHIPS Event Media Release Agreement USA RUGBY MEDIA WAIVER (MINORS) I hereby authorize and give my full consent to USA RUGBY to copyright and/or publish any and all photographs, videotapes, film, web casts/podcasts, and any other form of visual/audio communications in which I appear while attending any USA Rugby Championships event. I further agree that USA Rugby may transfer, use or cause to be used, these above mentioned communications for any exhibitions, public displays, publications, commercials, art and advertising purposes, and television programs without limitations or reservations. Signature Date Printed Name Parent/Guardian must sign: Signature of Parent/Guardian Date Printed Name of Parent/Guardian