NZRU & RPC Collective Agreement

Publication Notification Form

Name:

Contact telephone number:

Email address:

If you require assistance in the completion or interpretation on any aspects of this Notification Form or the purposes for which you are submitting it please contact eitheryour Professional Development Manager, the NZRU or the NZRPA.

This form, once completed, should be sent to the Player Services Advisor at the NZRU. You can either:

Email it to

send it by facsimile to: Toni McGregor-Tout (04) 494 0776;

courier it to:

New Zealand Rugby Union
100 Molesworth Street

Thorndon
WELLINGTON; or

post it to:

New Zealand Rugby Union
PO Box 2172
WELLINGTON

Details of the Publication

It is important that you provide asmuch information as possible to enable us to consider your Notification.Please include all available and relevant information to allow us to consider the Publicationfully and respond to your Notificationpromptly (you may attach other documents to this form).

What is the nature of the Publication? (eg article, book, web diary, mobile phone content, radio/TV appearance, match commentary etc)

Who is the publisher of the Publication?

Are any other players joining you as co-authors of, or participants in, the Publication? (if yes, please detail who the other player(s) are)

Where will the Publication appear?

When is the first date of publication?

When is the final date of publication?

Does thePublication require you to participate in advertising or other promotional activities or appearances?(if yes, please provide details)

Does the Publication require you to endorse or associate you in any way with the goods or services of a third party? (if yes, please provide details of the third party and the means of association)

Is there any other information you think will be relevant to this Notification?

(Please attach any relevant previews, scripts, draft boards, etc, of or related to thePublication)

Declaration of Player

I understand and acknowledge that, in the course of undertaking the Publication detailed in this Notification Form:

(i)I must not use, or allow the use of, any names or logos of the NZRU or Provincial Union, or the names, logos or uniforms of any New Zealand Team without first getting the consent of my provincial union and/or the NZRU;

(ii)the Publication must not bring the game of Rugby or the NZRU or a Provincial Union into disrepute;

(iii)the Publication must not breach the terms of the Collective Agreement;

(iv)the Publication must not involve the disclosure of confidential information, nor place the NZRU and/or a Provincial Union in breach of a contractual arrangement with a Sponsor or Broadcaster;

(v)the Publication must not involve the endorsement or association in any way with the goods or services of a third party (except as detailed in this Notification Form); and

(vi)NZRU maintains the right to object to this Publication. If NZRU does object you cannot undertake the Publication until the objection is resolved.

Signed: ______

Name: ______

Date:______

NZRU will acknowledge receipt of this Notification Form in writing to you.

NZRU will inform you of its response to this Notification within 5 working days of receiving the Notification Form and any other necessary information. NZRU will also provide you with written confirmation of its response.