George Pocock Rowing Foundation · Transportation Support: Unaccompanied Minor Release Form

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Transportation Support: Unaccompanied Minor Release Form

This form must be completed in order for minors, under the age of 18, to utilize Pocock Foundation transportation services provided in partnership with Hop Skip Drive or Seattle Yellow Cab.

This transportation service is only available for transportation to junior rowing at Mt. Baker Rowing and Sailing Center, Green Lake Crew, Pocock Rowing Center, or Renton Rowing Center.

Students utilizing this service will be given vouchers, which can be used to pay the driver for each ride. Students will also be given a designated pick up time and location so the cab knows exactly when and where to be each day.

Questions? Please contact our Community Partnerships and Scholarships Manager Delany Pelz by email at delany@pocockfoundation.org or by phone at 206-498-8286

PARENT/GUARDIAN AUTHORIZATION

NAME OF PARENT/GUARDIAN COMPLETING THIS RELEASE FORM

First Name

Last Name

NAME OF UNACCOMPANIED YOUTH PASSENGER

First Name

Last Name

Parent/Guardian Email

Address

Address Line 1

Address Line 2

City

State/Province

ZIP/Postal Code

Country

IMPORTANT ITEMS TO REVIEW PRIOR TO PARENT/GUARDIAN AUTHORIZATION

Is your child 13 years of age or older?

Your child must be at least 13 years of age in order to utilize taxi or rideshare services provided by the Pocock Foundation. If your child is younger than 13 years old, they may not utilize this transportation service.

My child is at least 13 years old.

My child is YOUNGER than 13 years old.

Is your child able to enter and exit the taxi or rideshare vehicle by themselves?

All youth riders must be able to get in and out of the taxi or rideshare service by themselves, without help from the driver.

Yes

Taxi or other rideshare services not assume any other responsibility for the unaccompanied minor passenger other than providing transportation between pick-up and drop-off locations.

I understand and agree to the statement above.

I do not agree to the statement above.

Parent/Guardian Authorization

Parent/Guardian Waiver for Participant Under the Age of 18

ADULT PARTICIPANT or PARENT/GUARDIAN AGREEMENT FOR ANY PARTICIPANT WHO IS NOT YET 18 YEARS OLD THIS WAIVER MUST BE READ AND ACCEPTED BY THE LEGAL GUARDIAN OF THE PARTICIPANT. By clicking Accept below, I hereby verify that as legal guardian of this participant, I have read and fully understand each of the following conditions for permitting my child to participate in transportation services provided by the Pocock Foundation and I accept each of the conditions below, especially the waiver and release set forth in paragraph one. I understand that my participation in transportation services provided by the Pocock Foundation involves risks of bodily injury, including paralysis, stroke, heart attack and death, as well as loss or damage to property. My decision to participate in transportation services provided by the Pocock Foundation is made by me in full recognition of these risks and is entirely voluntary. In consideration of your acceptance of this waiver and my entry in transportation services provided by the Pocock Foundation, I hereby agree for myself, executor, administrator and assigns, heirs, and anyone entitled to act on my behalf to hold harmless the George Pocock Rowing Foundation and its directors, officers, employees, representatives, agents, successors, and assigns all claims liability on account of injury, loss, claims or damage to my health, well-being or property on account of may participation in transportation services provided by the Pocock Foundation or traveling to or from this event. I know that a rowing ergometer race is a potentially hazardous activity. I should not enter transportation services provided by the Pocock Foundation unless I am medically and physically able. I agree to abide by any decision of a race official relative to my ability to safely complete this event. I assume all risks associated with participating in this event, all such risks being known and appreciated by me. I realize that this can be a and normally is a strenuous event which requires proper physical conditioning. I hereby certify that I am in such physical condition and good health. I also give permission for the free use of my name and picture in any written account, broadcast or telecast of this event for any legitimate purpose.

I have read and accept the statements above.

Electronic Signature

Please type your name in the space above to grant permission for your child to participate in taxi and rideshare services as provided by the Pocock Foundation.