ACCEPTANCE OF RISK, RELEASE AND WAIVER

As a participant in the Rugby Club, I recognize and acknowledge that there are certain risks of physical injury including, but not limited to death which may arise from accidents or other causes. I have no physical condition which would present a risk of injury to me through my participation in the Rugby Club. Notwithstanding any instruction or consultation by the University of Chicago Booth School of Business, the University of Chicago or the University of Chicago Medical Center (School), I agree to assume responsibility for any such injuries, damages or loss which I may sustain as a result of participating in any and all activities, including practices, matches, and tournaments connected with or associated with the Rugby Club except if caused by the sole negligence of the University of Chicago Booth School of Business, the University of Chicago or the University of Chicago Medical Center. I understand that School rules will be enforced. If I violate these rules, as determined by the School, I will not be able to continue participation in the Rugby Club.

MEDICAL CERTIFICATION, INFORMATION and
CONSENT for MEDICAL TREATMENT

I certify that I have no medical condition, allergy or other special dietary need that might subject me to injury as a result of my participation in the Rugby Club. I agree that participation in any Rugby Club activity will be at my own discretion and judgment. I will abide by all applicable safety rules. I understand that the School does not provide medical insurance to me. I certify that I have adequate medical insurance to pay for any medical services that may be required while I am participating in the Rugby Club. or to the extent my medical insurance does not provide benefits sufficient to cover the full costs of medical treatment, the foregoing waiver and release of the School shall include waiver and release of payment of medical bills incurred as a result of my participation in the Activity.

WAIVER and RELEASE

I acknowledge that my participation in the Rugby Club is voluntary. In consideration of my participation in the Rugby Club, I agree to assume all risks and responsibilities surrounding my participation in the Rugby Club including transportation to and from the Rugby Club, and hereby release, waive, forever discharge the School, its trustees, directors, officers, agents, and employees, from and against any and all liability for any harm, injury, damage, claims, demands, actions, causes of action, costs and expenses of any nature which I, my spouse or my family have, arising out of or related to any loss, damage, or injury, including but not limited to death, that may be sustained or by any property belonging to me, except to the extent caused by the sole negligence of the School. I have signed the Waiver and Release in full recognition and appreciation of the dangers, hazards, and risks of the activities associated with Rugby Club including but not limited to sprains/strains, concussion, contusions and fractures. In signing this Release, I acknowledge and represent that I fully understand the content of this Release. I have reviewed it and understand what it means, and that I sign this document freely. No oral representations, statements, or inducements, apart from the foregoing written statement, have been made. I understand that the School does not require me to participate in Rugby Club activities, but I want to do so, despite the possible dangers and risks and despite this Release. I further agree that this Release shall be construed in accordance with the laws of the State of Illinois. If any term or provision of this Release shall be held illegal, unenforceable, or in conflict with any law governing this Release, the remaining portions shall not be affected thereby.