Waiver Request for USARS National Championships

Waiver Request for USARS National Championships

This form can filled out by Athlete or Regional Meet Director
Please consult the appropriate rule book for the requirements necessary to complete this waiver for the next higher Championship.

The waiver requirement rules can be found in the following rule books:

- Elite: AR ED.107

- Youth: AR YD.109

- Adult: AR AD.111

Link to Rules Page on USARS Website

https://www.usarollersports.org/figure-w-full-nav/figure-skating-rules
Athletes Name*

First NameLast Name
Athletes Email*
example@example.com
Athletes USARS Membership ID Number*
Athletes Current USARS Club*
Athletes Current Coach*
USARS Region*
Regional Meet Director Name*
Has the athlete registered and paid the required entry fees for the Regional Championships by the entry deadline set by the Regional Meet Director?” *
Has athlete notified Regional Meet Director of this waiver request?*
How many skaters are in entered into your event(s) Please confirm with your Regional Meet Director*
Event(s) athlete is applying for with this waiver*
Athletes Reason for request of waiver*
Please upload supporting documents if available *

Cancelof
Please list all regional and national placements of athlete in related discipline (for team events please list partner).*
Should be Empty: