Form Wvssac - Application To State Association For Sanction Of Intrastate/interstate (Circle One) Athletic Event

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WVSSAC
Updated 3/23/04
APPLICATION TO STATE ASSOCIATION FOR SANCTION OF INTRASTATE/INTERSTATE (circle one) ATHLETIC EVENT
(For use when NFHS sanction is NOT required)
SECTION 1 (To be completed by host school)
Application Date ________________________________
Description of Event
•Sport: ________________________
Girls
Boys •Date of Event: ____________ •Time of Event ____________
•Grade Level: 6, 7, 8, 9, 10, 11, 12
•Site ___________________________________________
(Circle appropriate grades)
•Sponsor(s) _______________________________________________________________________________________
Member high school/other sponsoring organization
Street
City
State
Zip
•Name of Event (If applicable):: ________________________________________________________________________
•Schools invited from the following states ________________________________________________________________
(LIST ALL SCHOOLS & ADDRESSES ON PAGE 4)
•Number of participating schools:_________________________________
•Entry Fee:
Yes Amount: $________________
No
•Admission Fee Charged:
Yes
No
•Event will be managed by: ___________________________________________________________________________
State association approved school or other sponsor
City
State
Zip
Name of Manager (Director)/Title: ____________________________ Phone: ______________ Fax: _________________
Description of Awards and Other Compensations and Maximum Retail Value (ribbons/trophies/plaques/medals; waiver of
entry fee/travel expenses, etc.,) to:
(list below in proper category)
Individual Student Athlete Participants:
Teams:
Coach
Execution of this form constitutes an agreement by the principal of the host school to submit a financial report (interstate only) about the event to the state
association of the host school on the accompanying form within ninety (90) calendar days of the completion of the event. Execution also constitutes an
agreement by the principal to assume oversight responsibility for the event.
Executed by: ____________________________________ Phone: __________________ Date: ___________________
Principal of host school* Signature/Printed Name
After completing Section 1, send form to state association of host/sponsor or member school identified.
SECTION 2
ACTION BY STATE ASSOCIATION OF HOST SCHOOL
School Membership:
State Association Member School
School Approved by State Association
Non-Member School
Action:
Sanction Event
Do Not Sanction Event
No Jurisdiction
If “No Jurisdiction”, explain why: _______________________________________________________________________
________________________________________________________________________________________________
Limitations/Other Comments: _________________________________________________________________________
________________________________________________________________________________________________
Signature of State Executive: ____________________________ Date: ________________State: __________________
If event sanctioned, send copies to each state association named in application. If application is not sanctioned, return to applicant.
SECTION 3
ACTION BY STATE ASSOCIATION OF INVITED SCHOOLS
State Association Member School
School Approved by State Association
Non-Member School
School Membership:
(If more than one school invited, please indicate member status of each school next to the listing on Page 4)
Action:
Sanction Event
Do Not Sanction Event
No Jurisdiction
If “No Jurisdiction”, explain why: _______________________________________________________________________
________________________________________________________________________________________________
Limitations/Other Comments: _________________________________________________________________________
________________________________________________________________________________________________
Signature of State Executive: ____________________________ Date: ________________State: __________________
Forward a copy to host state association.
*If a state association, rather than a school, sponsors or co-sponsors the event, it’s executive director should sign here.
Page 3

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