TRAVEL PERMISSION FORM
SECTION XI
NEW YORK STATE PUBLIC HIGH SCHOOL ATHLETIC ASSOCIATION
180 EAST MAIN STREET, SUITE 302, SMITHTOWN, NY 11787
631-366-4900
Travel Permission Form
DATE______________________
Dear Parent and Student-Athlete,
Congratulations on qualifying to represent Section XI at the NYSPHSAA state
championships.
You are to be commended for the time, energy and effort that you have put into
your sport.
Attached or enclosed is information concerning the time and place of
competition, the mode of travel and lodging information. If an unusual
circumstance arises and you are unable to compete, please notify your high
school coach or athletic director as soon as possible.
The conduct of students while competing, traveling and living with other Section
team members is a matter of concern. Please be advised that you are subject to
all of the rules and regulations in your individual high school and the Section
XI Code of Conduct.
The use of alcohol, tobacco or drugs will result in disciplinary action which
includes automatic suspension from athletic competition. Delinquent conduct or
the destruction of property will result in disciplinary action as well as the
recovery of costs. Disciplinary action by Section XI will be in addition to
actions taken by your school district.
It is required that you will travel to and from the site of athletic competition
by the means provided by Section XI, otherwise you will not be permitted to
compete. The only exception to this requirement will be on the return home when
written notice has been provided in advance stating that you will be transported
home with your parents. That notification is to be given to the sport
chairperson.
PENALTIES FOR VIOLATION OF CODE OF CONDUCT
1. If a violation occurs prior to or during the contest the athlete will not be
allowed to compete or continue to compete. The Section will recommend
disciplinary action.
2. If a violation occurs after the competition the Section will make a
recommendation for disciplinary action.
3. If the situation is warranted to be serious the parents and school will be
notified. Immediate arrangements will be made to transport the athlete home.
*PARENTAL PERMISSION AND EMERGENCY CARD ON BACK MUST BE COMPLETED AND RETURNED
TO SPORT COORDINATOR
Revised 9/2016
Travel Permission Form
Student Name: ____________________________________
Parent Name: ____________________________________
School: ____________________________________
Home Address: ____________________________________
____________________________________
Phone: Day: _________________ Night: ___________________
Medical Conditions: Allergies: _________________________________________
Other: ____________________________________________________________
Two persons to contact in case of emergency other than parent or guardian:
Name: ______________________________________ Phone: ________________
Name: _______________________________________ Phone: ________________
Signature of Student: ____________________________________________
Signature of Parent: ____________________________________________
This form must be returned to the Sports Chairperson prior to departure for the
competition.
Thank you and good luck!
Revised 9/2016