*Keep this page for your own personal records

RETURN PAGES 2 & 3 AND CHECK no later than WED. 10/18

(to Mr. Niewoehner room 227/228)
Rock Bridge Speech & Debate Team
Tournament Information: Parkway West HS
Tournament Date: October 20-21, 2017
Parkway West HS
Location:
14653 Clayton Rd., Ballwin, MO 63011

Earth City Marriott (Springhill Suites)

Hotel: 3290 Rider Trail South
Earth City, MO 63045
(844) 569-4549

Attending Coaches: Mr. Ben Niewoehner (314) 482-2667

Mr. Matt Johnson (952) 250-0484
Itinerary
1. Students will be released from class at 11:30 a.m. on Friday, and the bus will arrive in STL around 2:00
p.m.
2. Students will contact their parents on Saturday evening when leaving STL to provide their return time,
as it is currently undetermined (although it cannot be guaranteed, we will do our best to try and return to
Columbia by 12:00 a.m.)
Non-driving students need to have a plan in place on how they will get home on Saturday
evening. It is imperative that rides be available the moment the bus returns students to
Rock Bridge. Coaches will not be entering the building or giving students rides home. It is
also hard on the coaches if they have to wait for someone to pick up a student.

Student Needs
- $30 to cover the cost of the hotel and transportation. Please make checks payable to CPS.
(Cash cannot be accepted.)
- Spending money for meals and snacks. Students can also bring their own food.
- We will be stopping by a grocery store on Friday night for dinner. Breakfast will be available in
the hotel, and there will be a concession stand at the tournament.
- Business attire for the competition, and all competition materials.
- Casual clothing, pajamas, swim suit, and toiletries.

Contact Information
If you have any questions or concerns, please contact:

Ben Niewoehner Matt Johnson

RBHS Speech & Debate Coach RBHS Assistant Coach
(314) 482-2667 (952) 250-0484
bniewoehner@cpsk12.org mjohnson@cpsk12.org

1
 Rock Bridge Speech & Debate
Tournament Registration: Parkway West HS

NAME _________________________________________________ GRADE ______________

CELL # (FOR CONTACT AT TOURNAMENT) ___________________________________
EMAIL ______________________________________________________________________
EVENTS _____________________________________________________________________
PARTNER(S) _________________________________________________________________

ELIGIBILITY

WORKSHOP & SUBMISSION REQUIREMENTS:

Did you perform all events for a chair, captain, or coach prior to this tournament? Yes No

Are you competing in extemp? Yes No

If yes, how many files did you submit immediately prior to this tournament? _______________

MSHSAA REQUIREMENTS

Must meet MSHSAA eligibility to attend tournaments in any capacity: i.e. competing, moral
support, etc. It will be communicated to you if you cannot attend due to this factor. See the
Membership Agreement for details on MSHSAA eligibility.

STUDENT AGREEMENT

I, _____________________________ agree to follow all tournament and public school policies.

_____________________________________________________________________________
(Student signature and Date)

*Note: Please attach your tournament fee ($30) to this document in an envelope. Make all checks
out to CPS. (Cash cannot be accepted).

2
 Rock Bridge Speech & Debate
Student/Parent Information

NAME ____________________________________________________ GRADE __________

EMERGENCY CONTACT INFORMATION

PARENT/GUARDIAN #1 ______________________________________________________
Cell # _______________________________ Other # __________________________________
Email ________________________________________________________________________
PARENT/GUARDIAN #2 ______________________________________________________
Cell # _______________________________ Other # __________________________________
Email ________________________________________________________________________
EMERGENCY CONTACT _____________________________________________________
Relationship ________________________________ Phone # ___________________________

NONE OF THE CONCERNS LISTED IN THE BOX BELOW APPLY

Medical concerns (diabetes, asthma, ADHD/ADD, etc.):
If yes, please explain:

Allergies: Please list

Has an allergy required emergency action in the past? Yes No
Describe reaction:

Other Accommodations:
If yes, please explain:

PARENTAL CONSENT
I give my permission for _________________________________________ to attend all of the
tournaments with the Rock Bridge Speech & Debate team (pending teacher/school/MSHSAA
consent based on eligibility). All tournament trips are CPS-endorsed. I understand that the
participants are expected to follow all rules and policies common with public school use.

___________________________________________________________________________
(Parent/guardian signature and Date)