2017 USA Rugby Fall College Playoffs Women s DI Round of 8 Men s & Women s DII Round of 16 Lemont, Illinois November 18-19, 2017
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1 2017 USA Rugby Fall College Playoffs Women s DI Round of 8 Men s & Women s DII Round of 16 Lemont, Illinois November 18-19, 2017 Chicago Blaze Rugby Club West Smith Road Lemont, IL CONTACTS USA Rugby On-Site: Jess Dombrowski jdombrowski@usarugby.org USA Rugby National Office: Aaron Kaylor akaylor@usarugby.org USA Rugby Eligibility: Justin Holshuh eligibility@usarugby.org Host Contact: Al Klemp alklemp@aol.com OFFICIAL HOTEL The Holiday Inn Hotel & Suites Bolingbrook is the official hotel for this event. They have offered a reduced rate of $99/night including breakfast for 4 people and are only 7 miles from the venue. Call and use the code CBB Or book online at and click More Options to use the code CBB *Rooms must be booked by Thursday, Nov. 9th to secure this rate. ELIGIBILITY Please contact Justin Holshuh (eligibility@usarugby.org) with any questions related to eligibility or to request a waiver of eligibility. Championship paperwork should be directed to ncspaperwork@usarugby.org. 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, an Athletics, Club/Recreational Sports, or Student Services Department representative, and a representative from your Conference. 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 ncspaperwork@usarugby.org. Step 3 *If any rostered member of your team has received an eligibility waiver for any purpose, please include a copy of that waiver along with your form. Collegiate Player Eligibility Form: To be completed prior to competition in USA Rugby College Playoffs and Championship Events. Completed forms should be forwarded to ncspaperwork@usarugby.org.
2 2017 USA Rugby Fall College Playoffs Women s DI Round of 8 Men s & Women s DII Round of 16 Lemont, Illinois November 18-19, 2017 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 must 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 completion of all six steps. Championship paperwork may be returned to ncspaperwork@usarugby.org. TRAINING SCHEDULE Please call Al Klemp ( ) if you would like to secure field space on Friday. CHECK-IN Eligibility Check-In will be conducted the evening of Friday, November 17th at the Chicago Blaze Clubhouse. Each team will have a 15 minute block for their eligibility check-in based on travel distance from the venue. - 5:00 PM Illinois State - 5:15 PM Davenport - 5:30 PM UW La Crosse - 5:45 PM Winona State - 6:00 PM CO School of Mines - 6:15 PM Minnesota - 6:30 PM North Dakota State - 6:45 PM Furman - 7:00 PM Sam Houston State - 7:15 PM Texas A&M - 7:30 PM Air Force - 7:45 PM Montana State All rostered players must present a government or school issued photo ID at check-in. The Coaches & Captains Meeting will take place from 8-8:30 at the same location. VENUE Both pitches have bleacher seating and are adjacent to one another. There is also a third pitch for warmups. The Blaze clubhouse has showers for teams who are getting on the road immediately after their matches on Sunday Paid parking is available on site as well as a shuttle for off-site parking The Blaze also have a bar in the clubhouse that will be open throughout the event.
3 2017 USA Rugby Fall College Playoffs Women s DI Round of 8 Men s & Women s DII Round of 16 Lemont, Illinois November 18-19, 2017
4 2017 USA Rugby Fall College Playoffs Women s DI Round of 8 Men s & Women s DII Round of 16 Lemont, Illinois November 18-19, Championship Checklist - USA Rugby College Playoffs Championship paperwork may be returned to ncspaperwork@usarugby.org Form Due Date Format Complete 1. Team Contact Information Form Wednesday, Nov. 8 Online 2. Team Participation Agreement Must include signature of College/University Rep. and Conference Rep. Wednesday, Nov Collegiate Player Eligibility Form Teams may check-in more than 23 players but must only have 23 on the match roster. Wednesday, Nov Participation Waivers (Required of all participants) Minor players will require parent/guardian signatures on the waiver AND U18 Participation in College Rugby paperwork, present at check-in. Check-In Nov. 17 Hard Copy 5. Event Media Release Agreement Must include signatures of all participants and sideline staff Minors must also complete a minor media waiver form Check-In Nov. 17 Hard Copy
5 Team Participation Agreement 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. 8. The team understands that all applications of Regulation 20 in the World Rugby Handbook regarding misconduct and discipline will be applied and enforced at all USA Rugby National Championship Series events. a. Misconduct shall mean any conduct, behavior, statements and/or practices on or off the playing enclosure during or in connection with a Match or otherwise, that is unsporting and/or cheating and/or insulting and/or unruly and/or ill-disciplined and/or that brings or has the potential to bring the Game and/or any of its constituent bodies, World Rugby and/or its appointed personnel or commercial partners and/or Match Officials and/or judicial personnel into disrepute. b. USA Rugby will appoint a designated disciplinary officer who shall administer this Regulation and shall be entitled to undertake such investigations (personally or through a nominee(s)) as he may consider necessary into incidents that constitute or may be capable of constituting Misconduct on the part of the Players and/or Persons and/or Rugby Bodies within their jurisdiction in accordance with Regulation 20. Team Rep Initial College/University Rep Initial Conference Rep Initial
6 9. 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 to 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. 10. 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. 11. The Team agrees that this agreement shall be governed by and construed in accordance with the rules, regulations and guidelines of USA Rugby. 12. 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: *Please include initials at bottom of Page 1 Team Rep Initial 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 2016 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 phototgraphs, 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
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