LONG VALLEY RAIDERS CHEERLEADING ASSOCIATION

EXCEPTION APPROVAL REQUEST

Date:  _______________________________________________________________________

Name of Child:________________________________________________________________

Parents Name(s):______________________________________________________________

Telephone No.:________________________________________________________________

Squad Child is On or is Trying Out for:______________________________________________

(Pre-Clinic, Clinic, Super PW, PW, JV, Varsity)

Please provide the specifics as to why you are requesting approval to have your child miss all or a portion of the following activities:  (Spirit Camp, Summer Practice, Summer Camp, Skills Clinic, Fall Practices, Other)

Date of Special Board Meeting:___________________________________________________

Board Members In Attendance:___________________________________________________

Board Decision:       Approved                      Denied             

Results of Board Vote:__________________________

(e.g., Approved 6-1, Denied 4-3, etc.)