2019-20 SPECIAL CIRCUMSTANCE PERMISSION REQUEST AND RELEASE
Use this form if your rower will NOT be riding on the Bus with the SLRC team either TO the Regatta or FROM the regatta.

The SLRC Regatta Travel Policy expects that all team members are to travel with the team. Separate transportation and/or lodging requests must be submitted to the Junior Program Coordinators at juniorprogram@stlouisrowinclub.com at least 10 days in advance of the regatta departure date. It is understood and agreed that by signing this Request Form, Rower and Rower’s Parent/Guardian acknowledge that this constitutes a waiver and release of liability of SLRC in connection with this Request. SLRC will not permit Junior Rowers to drive themselves or other Junior Rowers to or from regattas. Rowers not traveling with the team or staying with the team must nonetheless pay the full amount of the regatta fees charged for the event.
Date *
MM
/
DD
/
YYYY
The undersigned requests that: (Name of Rower) *
Your answer
Excused from the regatta:
Head of the Rock (October 13th, 2019)
Blake Haxton (October 26th, 2019)
Head of the Hooch (November 2-3rd)
Frostbite Regatta (November 3rd)
Oklahoma City (March 21st 2020)
Cincy Invite (April 4th, 2020)
Dogwood Sprints (April 25-26th, 2020)
MidWest Championships (May 16-17, 2020)
Select 1 or more
For the following Reason:
Your answer
Alternate Transportation:
Rower will Ride with: (Name)
Your answer
Reason they are not taking club transportation:
Your answer
Hotel- We are requesting to be permitted to stay in alternative lodging, separate from the team, for the following reason(s):
Your answer
The Rower will be accompanied at all times when the Rower is not with the team, by: *
Your answer
Contact Number: (cell phone) *
Your answer
Electronic Signature: *
Parent Name Submitting Form *
Your answer
Parent Cell Phone Number: *
Your answer
Submit
Never submit passwords through Google Forms.
This form was created inside of St. Louis Rowing Club. Report Abuse - Terms of Service