Travel Release Form
Union City Jr-Sr High School
603 N Walnut St
Union City, IN 47390
Phone: 765-964-4840

Mr. Mike Thornburg
Athletic Director

Contest Travel Release
The Department of Athletics wants to emphasize the importance of student-athletes riding the team bus to and from athletic events. The riding of the team bus creates a bond – a team unity among teammates and coaches. It is an educational classroom where coaches can discuss team goals, strategies, give skill, game or practice instructions. A place where a coach can console, congratulate, or motivate an athlete. It is where the athlete and coach have an opportunity to communicate without any interruptions or outside interference. It is an environment that cannot be duplicated or recaptured at any other time than at that moment.

Under certain circumstances or exceptional situations, athletes may be excused from riding either to or from an athletic event on school authorized transportation. Form must be filled out by 3:00 PM on week night events and by 8:00 PM on Friday for Saturday event to give AD time to approve.

Student Name
Your answer
Parent/Guardian Name completing this form
Your answer
Sport
Your answer
Event Location
Your answer
Date of Event
MM
/
DD
/
YYYY
Requesting permission for the above mentioned student to ride to and/or from the above mentioned event with an adult (non-student) of the parent/guardian's choice.
Required
Name of adult providing transportation
Your answer
The reason for not riding the bus is
(Reason must be sufficiently urgent to family needs to justify not riding the bus)
Your answer
Coach's Name
Your answer
Has above coach been notified AND given permission for this release?
I understand that the Union City Jr High/High School Athletic rules require students to ride the buses to and from all athletic events and departure from this requirement will release the Randolph Eastern School Corporation from all liability for any adverse results that may occur.

I agree to release the Randolph Eastern School Corporation and its employees and officers from all liability with reference to the above-stated transportation.

This form must be submitted and on file in the Athletic Office prior to the dismissal of school on the day of the contest.

By typing your name below you are giving an electronic signature that acknowledges that you have read and agree to the above information.
(Name here MUST match name in the parent/guardian box above.)
Your answer
Parent E-mail
An e-mail confirming receipt of this request will be sent by the Athletic Department
Your answer
Submit
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