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2011 Makassar 10s Rugby Tournament

- Registration Form -

Please fill out form and submit to Matano Miners admin before your first game on Saturday 5 th
February.

TEAM NAME: ……………………………………………………………..

TEAM MANAGER: ……………………………………………………….

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The above said players hereby indemnify the tournament organizers from any injuries (severe or
minor) or fatalities arising in particular in the said tournament. All participants are deemed to
have their own medical insurance/ policies or any other similar coverage whilst participating in
the said tournament.

Acknowledged on behalf of the team:

Team Manager and Signature ………………………………………………………………………

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