Application For Sanction Of A Usa Volleyball Team Practice Form Page 2
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1
2USA Volleyball
2010-2011 Application for Sanction of a
Team Practice
DETAILS OF PRACTICE(S)
Site 1
Site 2
Site 3
Site 4
# of Participants
# of Courts Available
# of Courts to be Used
Site 1
Site 2
Site 3
Site 4
Projected Weekly Income
$
$
$
$
Projected Weekly Expenses
$
$
$
$
Projected Weekly Profit/(Loss)
$
$
$
$
INSURANCE CERTIFICATES
General Certificate
A General Insurance Certificate stating the insurance coverage can be issued once the sanction request has been approved. This insurance coverage
.
can include WEVA (as an entity) or an individual WEVA club
Site 1
Site 2
Site 3
Site 4
YES
NO
YES
NO
YES
NO
YES
NO
Is a General Certificate Required?
Certificate of Additionally Insured
Sometimes a facility requires that they or their employees are named as an additionally insured party on the certificate. This information is necessary
for the processing of the insurance certificate.
Site 1
Site 2
Site 3
Site 4
YES
NO
YES
NO
YES
NO
YES
NO
Is a Certificate for Additionally Insured Required?
If YES, what are the names of the Additionally Insured parties?
Site 1: _________________________________________________________________________________________________
Site 2: _________________________________________________________________________________________________
Site 3: _________________________________________________________________________________________________
Site 4: _________________________________________________________________________________________________
The insurance certificates will be mailed/forwarded to you from the WEVA Sanction Coordinator.
Please allow enough time for the WEVA Sanction Coordinator to process your request with the insurance provider. You should allow
a minimum of three weeks for processing, from the date an event is sanctioned, before the USA Volleyball insurance provider will
issue a certificate.
The above practices are / are not sanctioned based on the following conditions:
_____________________________________________________________________________________________________
_____________________________________________________________________________________________________
_____________________________________________________________________________________________________
WEVA Sanction Coordinator: _________________________________________
Date:
______________
WEVA Commissioner: ________________________________________________
Date:
______________
W
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V
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estern
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olleyball
ssociation
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