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TRAVEL CONSENT FORM

2019 Xmas Regatta

December 8

Marine Stadium, Long Beach 

This form must be completed by the athlete's parent, even if the athlete is over the age of 18.

Completion of this form verifies that the athlete's parent acknowledges the athlete's travel itinerary for the event.

Completion of this form verifies that the athlete's parent acknowledges that their athlete shall be deemed to have waived all claims against the NAC, it's officers and employees or parent volunteers for any injury, accident, illness or death occurring during or by reason of travel to and from this event. 

Any additional travel arrangements or costs (i.e. fuel, airfare) that are required as a result of the athlete’s travel plans are the sole responsibility of the parent.

The NAC staff will not be involved or responsible for any travel arrangements.

The athlete will not be considered under the supervision of the NAC staff until arrival to the event or upon departure from the event.

REQUIREMENT: ATHLETE MUST BE TRANSPORTED BY THEIR PARENT, GUARDIAN OR A PARENT OF ANOTHER ATHLETE. If unable to comply with this requirement, you must get approval from the Head Coach prior to completion of this form.*

Your Head Coach must be notified of any changes made to your athlete’s travel plans after this form is completed. 

 

*Requirement is waived for all Long Beach Regattas. Athletes are allowed to drive themselves and others with all parents' permission. 

 

This form must be completed FIVE (5) DAYS PRIOR to the event. Your athlete's coach will be tracking the forms and failure to comply will result in the athlete not being able to participate in the event. 

I Agree

Disregard the "Adult" button. Please select "Minor(s)." If you have more than one athlete, please complete separate forms.
AdultMinor(s)
1 Minor2 Minors3 Minors4 Minors5 MinorsMore Minors6 Minors7 Minors8 Minors9 Minors10 Minors
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First Athlete's Name

First Name*

Last Name*
First Athlete's Date of Birth*
I certify that I am 19 years of age or older
First Athlete's Travel Information
Athlete's Team*

Name of Individual Transporting Athlete *

Relationship to Athlete (i.e. parent, teammate, etc) *

Passengers (if applicable)
First Athlete's Signature*
Second Athlete's Name

First Name*

Last Name*
Second Athlete's Date of Birth*
Second Athlete's Travel Information
Athlete's Team*

Name of Individual Transporting Athlete *

Relationship to Athlete (i.e. parent, teammate, etc) *

Passengers (if applicable)
Third Athlete's Name

First Name*

Last Name*
Third Athlete's Date of Birth*
Third Athlete's Travel Information
Athlete's Team*

Name of Individual Transporting Athlete *

Relationship to Athlete (i.e. parent, teammate, etc) *

Passengers (if applicable)
Fourth Athlete's Name

First Name*

Last Name*
Fourth Athlete's Date of Birth*
Fourth Athlete's Travel Information
Athlete's Team*

Name of Individual Transporting Athlete *

Relationship to Athlete (i.e. parent, teammate, etc) *

Passengers (if applicable)
Fifth Athlete's Name

First Name*

Last Name*
Fifth Athlete's Date of Birth*
Fifth Athlete's Travel Information
Athlete's Team*

Name of Individual Transporting Athlete *

Relationship to Athlete (i.e. parent, teammate, etc) *

Passengers (if applicable)
Sixth Athlete's Name

First Name*

Last Name*
Sixth Athlete's Date of Birth*
Sixth Athlete's Travel Information
Athlete's Team*

Name of Individual Transporting Athlete *

Relationship to Athlete (i.e. parent, teammate, etc) *

Passengers (if applicable)
Seventh Athlete's Name

First Name*

Last Name*
Seventh Athlete's Date of Birth*
Seventh Athlete's Travel Information
Athlete's Team*

Name of Individual Transporting Athlete *

Relationship to Athlete (i.e. parent, teammate, etc) *

Passengers (if applicable)
Eighth Athlete's Name

First Name*

Last Name*
Eighth Athlete's Date of Birth*
Eighth Athlete's Travel Information
Athlete's Team*

Name of Individual Transporting Athlete *

Relationship to Athlete (i.e. parent, teammate, etc) *

Passengers (if applicable)
Ninth Athlete's Name

First Name*

Last Name*
Ninth Athlete's Date of Birth*
Ninth Athlete's Travel Information
Athlete's Team*

Name of Individual Transporting Athlete *

Relationship to Athlete (i.e. parent, teammate, etc) *

Passengers (if applicable)
Tenth Athlete's Name

First Name*

Last Name*
Tenth Athlete's Date of Birth*
Tenth Athlete's Travel Information
Athlete's Team*

Name of Individual Transporting Athlete *

Relationship to Athlete (i.e. parent, teammate, etc) *

Passengers (if applicable)
Parent or Guardian's Email Address

Email
A signed copy of this waiver will be sent to the email address you provide.
Parent(s) or court-appointed legal guardian(s) must sign for any participating minor (those under 18 years of age) and agree that they and the minor are subject to all the terms of this document, as set forth above.
Parent or Guardian's Name

First Name*

Last Name*
Parent or Guardian's Date of Birth*
I certify that I am 19 years of age or older
Parent or Guardian's Travel Information
Athlete's Team*

Name of Individual Transporting Athlete *

Relationship to Athlete (i.e. parent, teammate, etc) *

Passengers (if applicable)
Parent or Guardian's Signature*
Electronic Signature Consent*
By checking here, you are consenting to the use of your electronic signature in lieu of an original signature on paper. You have the right to request that you sign a paper copy instead. By checking here, you are waiving that right. After consent, you may, upon written request to us, obtain a paper copy of an electronic record. No fee will be charged for such copy and no special hardware or software is required to view it. Your agreement to use an electronic signature with us for any documents will continue until such time as you notify us in writing that you no longer wish to use an electronic signature. There is no penalty for withdrawing your consent. You should always make sure that we have a current email address in order to contact you regarding any changes, if necessary.


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