International Rugby Board - Player Release / Permission to Play Abroad Form
1. Player Givename(s)
*
2. Player Surname
*
3. Address of Player
*
4. Name of Provincial Union and Club with which Player is registered currently
*
5. Name of National Union with which Player is affilliated (current union)
*
6. Name of Union Player is eligible to play International Matches
*
7. Highest level at which the Player has played whilst Registered in Current Union, ie International, Provincial, Representative, Premier or other Club level
*
8. When did Player play at this level?
*
9. Which Union does the Player intend to Register and play (New Union)
*
10. Name of the Club (in new Union - if known)
11. If the Player is a Contracted Player, what is the date on which his/her written agreement within their Current Union will come to an end?
*
12. If the Player is a non-contracted Player, are they entering into a written agreement with a rugby body outside his home Union?
Yes
No
Unsure
DECLARATION OF CURRENT UNION
1. The information set out above is true and correct in every respect.
2. The Player is not currently under suspension on disciplinary grounds (which, for the avoidance of doubt, shall include any Doping Offence) for a period of more than five weeks. The New Union has agreed that any current suspension of the Player shall apply to matches played under its jurisdiction.
3. If the Player is a Contract Player, the Player has no outstanding obligations under the terms of his written agreement with his Union, Rugby Body or Club.
Player Signature:_______________________________________________________
An authorised signatory on behalf of:____________________________________________________ (Current Club)
Name: (Print)_________________________________________________________________
Signed:________________________________________________________
Acknowledged and approved by: (Current Union) ________________________________________
Signed:________________________________________________________
Name: (Print)_________________________________________________________________
Date Recieved (Current Union): ____ /____ / 20___
Acknowledged and approved by: (New Union) ________________________________________
Name: (Print)_________________________________________________________________
Signed:________________________________________________________
Date Recieved (New Union): ____ /____ / 20___
Note: Regardless of the signature and dating of this Clearance, this Clearance shall only become effective when:-
i) the New Union has received an original version (or a facsimile copy of the original version) of the Clearance;
ii) the Player’s written agreement with his Current Union has expired or been terminated; and
iii) the Player’s Registration within his Current Union has been cancelled
Capitalised terms used in this Clearance shall have the meaning given to them in the IRB Regulations Relating to the Game (as amended from time to time).
