TEXAS RUGBY UNION FRONT ROW WAIVER FORM
Each Team Manager/Coach is required to present this form together with a current CIPP listing for his/her club to the referee prior to any match commencing.
No game will commence if the referee does not receive this completed form. CIPP registration of all
participants fulfills USARFU minimum insurance requirements. “Suitably Trained and Experienced” means that a player has received the requisite physical training and contact experience to withstand the forces exerted
in a scrum and has been instructed in safe scrummaging technique.
I hereby certify that the attached CIPP list for my club shows the most recent posting to the USA Rugby website and that only those players marked as front row players will be allowed to play in those positions during this game. Props and Hookers must be identified by specific Front Row position. I understand the provisions of the Laws of the Game (as published by the IRB and the USARFU) pertaining to Replacement or Substitute players and to Scrums. I understand that Scrums must be Un-Contested if players other than those marked are allowed to play in the front row. I also acknowledge that, if my team is responsible for uncontested scrums, then my team will not be able to bring on a replacement player and must continue with 14 (or fewer) players.
By signing this form I (as Team Manager/Coach) hereby declare that all of the players listed/identified as front row players on the CIPP listing have been properly coached and trained in generally accepted scrummaging techniques and are Suitably Trained & experienced to participate in this match.
Fixture ___________________ vs. ________________ Division ______
Date ___________________________ Venue ___________________________
_____________________________________________________________________________________
Signature Printed name Club
Number of front-row qualified players identified on CIPP Roster _____
Number of players identified on CIPP Roster _____
Roster Grid:
Number of reserve players on the roster who are experienced Front Row Players = Required number of suitably trained and experienced Front row players on the roster for substitution:
0 = 3
1, 2, or 3 = 4
4, 5, or 6 = 5
7 or 8 = 6
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