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Statutory Declaration from Players Attending Gathering at on 3 July 2021

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Statutory Declaration from Players Attending Gathering at on 3 July 2021 Statutory Declaration from Players attending gathering at on 3 July 2021 Note to all Players • Below is a Statutory Declaration which the NRL requires be completed by Players attending the gathering at on 3 July 2021 as part of their application to re- enter the Club’s Apollo bubble. • It has been prepared based on the answers provided during interviews with the NRL Integrity & Compliance Unit and reflects the NRL’s current understanding of the events of that day. • Completion of the Statutory Declaration is required as part of your application to re-enter your Club’s Apollo bubble. • As part of your application to re-enter your Club’s Apollo bubble, please either: (a) confirm that understanding through the completion of the below Statutory Declaration, or (b) immediately advise your Club CEO of any matters set out below which are incorrect or which require further explanation. If any matters set out below are incorrect or which require further explanation, do not sign the Statutory Declaration and contact your Club CEO immediately. • As the matters below also forms part of the Breach Notice issued to you, if you consider making this declaration affects your ability to respond to the Breach Notice, do not sign the Statutory Declaration and contact your Club CEO immediately. • If you would like to discuss the above with the RLPA, the Association can be contacted on 02 8732 1700. Statutory Declaration STATUTORY DECLARATION Oaths Act NSW 1900 I, _________________________ [print your name], do hereby solemnly declare and affirm that: 1. I am a registered NRL Player with the St George-Illawarra Dragons (my Club) and am a member of the Club’s Apollo Protocol Register. 2. I understand that my entry on the Club’s Apollo Protocol Register means that I must comply with the NRL’s Apollo Protocols at all times. 3. I have received from my Club a copy of the NRL’s Player & Club Apollo Protocols (Level 4) together with a One-Sheet summary of my key obligations and I understand how the obligations, restrictions and requirements in those documents apply to me. 4. I understand: a. the NRL Code of Conduct and the Player & Club Apollo Protocols require that I must at all times provide complete and accurate information in relation to any obligations under the NRL Rules and the Apollo Protocols; b. that this does not just mean answering questions I am asked fully and correctly, but volunteering information which is relevant to the proper operation of the Protocols (for example, where I know or suspect something has happened which is not allowed by the Protocols or government health orders, even if I have not been asked directly about it); c. that this also means that I must not provide inaccurate or misleading information to questionnaires, surveys and data collection by NRL Apollo, and that I must not individually, or through colluding with others, knowingly or deliberately undermine the measures and requirements outlined in the Apollo Protocols; d. that I am subject to significant penalties under the NRL Rules for the provision of incomplete, misleading or false information, or the failure to volunteer relevant information, in relation to biosecurity matters the subject of the Apollo Protocols; and e. that the information I provide is relied upon by my Club and the NRL as part of determining the biosecurity measures which apply to me, my teammates and the Club, and are very important to ensuring the safety myself and of those I work and live with. 5. I have disclosed all relevant information to the NRL concerning or related to my attendance at the home of my teammate Paul Vaughan at NSW (the Vaughan Residence) on 3 July 2021 between 2pm and midnight (the Gathering) through my interviews with the NRL Integrity & Compliance Unit on 4 and 5 July 2021. 6. Specifically, I confirm the following as true and correct in relation to my travel to, attendance at and travel from the Gathering: Date: Player Initials: 4 Statutory Declaration a. [strike through the statement which does not apply] I travelled to the Vaughan Residence by private car and the only occupants of the car during that trip were members of my Club Apollo bubble, my household or the members of a teammate’s household / I travelled to the Vaughan Residence by private car with the following other occupants ___________________________________________[name occupants]; b. No part of my journey from my residence to the Vaughan Residence involved the use of public transport or ride-share (Uber or similar service); c. [strike-through the statement which does not apply] i. I did not make any stops on the journey from my residence to the Vaughan Residence OR ii. I only stopped on the journey from my residence to the Vaughan Residence to perform the following tasks: _____________________________________________________________ _____________________________________________________________ _____________________________________________________________ and I wore a mask as required by the Apollo Protocol at all times; d. To the best of my knowledge, the only persons present in the Vaughan Residence during the Gathering were: i. Paul Vaughan and his immediate family members; ii. Blake Lawrie; iii. Corey Norman; iv. Daniel Alvaro; v. Gerard Beale; vi. Jack Bird; vii. Jack de Belin; viii. Josh Kerr; ix. Josh McGuire; x. Kaide Ellis; xi. Matt Dufty; Date: Player Initials: 4 Statutory Declaration xii. Tyrell Fuimaono; xiii. Zac Lomax (the Attendees). e. it is my honest understanding and belief, based on what I saw and heard whilst I was present in the Vaughan Residence, and also based on what I have been reliably told by others who were present (either during the time I was at the Vaughan Residence or in the days following): i. that apart from the Attendees listed above, no other person was present in the Vaughan Residence during the Gathering, apart from attending NSW Police; ii. that no other person attended the Vaughan Residence, even if only briefly and even if they stayed outside the front door, to deliver any food, drink or other items to the Vaughan Residence during the Gathering. f. that I have disclosed all information to the NRL Integrity & Compliance Unit about who may have been inside, stopped-by, or delivered anything to the Vaughan Residence during the Gathering, even if it is something which I have only been told by someone else present and cannot myself verify as true or not; g. that I left the Vaughan Residence prior to 11:59pm on Saturday, 3 July 2021; h. [strike through the statement which does not apply] that I travelled from the Vaughan Residence to my residence by private car and the occupants of the car during that trip were only members of my Club bubble, my household or members of a teammate’s household / I travelled from the Vaughan Residence by private car with the following other occupants ___________________________________________[name occupants]; i. that I did not make any stops on my journey from the Vaughan Residence to my residence, other than to deliver other attendees of the Gathering to their residence; j. that no part of my journey from the Vaughan Residence involved the use of public transport or ride-share (Uber or similar service); k. that since Saturday evening, I have strictly observed the Apollo Player and Club Protocols (Level 4). 7. I understand that the NRL requires these confirmations as part of my application to be re- admitted to the Club’s biosecurity bubble, and that the NRL will be relying upon these confirmations in assessing that application. 8. I have read the above carefully and been offered the opportunity to make changes should I consider any of the above to be inaccurate or incomplete. I understand and acknowledge that if I provide false, incomplete or inaccurate information in this Statutory Declaration I shall be subject to significant penalties under the NRL Rules. Date: Player Initials: 4 Statutory Declaration 9. I also understand: a. that this Statutory Declaration is made pursuant to the provisions of the Oaths Act 1900 (NSW); and b. that the making of declarations which are known to be untrue in any material way is an offence under NSW law. And I make this solemn declaration as to the matters aforesaid, according to the law in this behalf made – and subject to the punishment by law provided for any wilfully false statement in any such declaration: Declared at: on [place] [date] Signature of Declarant In the presence of an authorised witness, who states: I, a [name of authorised witness] [qualification of authorised witness] certify the following matters concerning the making of this statutory declaration by the person who made it: [*please cross out any text that does not apply] 1. *I saw the face of the person OR *I did not see the face of the person because the person was wearing a face covering, but I am satisfied that the person had special justification1 for not removing the covering; and 2. *I have known the person for at least 12 months OR *I have confirmed the person’s identity using an identification document and the document I relied upon was: [describe identification document relied upon [Signature of authorised witness [date] 1 The only “special justification” for not removing a face covering is a legitimate medical reason (at September 2018). Date: Player Initials: 4 .
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