United States Amateur Boxing, Inc.

Sanction Application/Official Sanction Form A Copy of this Sanction must be displayed in the weigh-in room or other conspicuous place

USA Boxing, Local Boxing Committee (LBC) Name

THIS FORM MUST BE COMPLETED IN ITS ENTIRETY The LBC must forward a copy of this form to USA Boxing’s Headquarters.

Registered USA Boxing Club Name, Address

City State Zip

Apply on behalf of for sanction to hold boxing competition in

City State Zip

Sanction applicant is a not for profit organization. (must check to indicate “yes”)

Official Name of Event

Site Address

City State Zip

Time one the day(s) of 200

Sponsoring Organization

Sanction applicant agrees to complete and submit the USA Boxing “Event Financial Report Form” to the LBC within 30 days of the conclusion of said event. (must check to indicate “yes”)

Type of Event (Circle One)

LBC Tournament; Golden Gloves Tournament, Regional Tournament, Club Competition, Other

Will boxers under 18 years of age be participating ? Yes No If yes, 1 parent of each minor athlete must receive admission to the event for no more than $5. Free admission is recommended and encouraged for at least one parent of each participating minor.

International Club Competition (name country involved)

Is this event a fund-raiser? Yes No If yes, please provide the organization(s) that will benefit. ______

Level of Competition Senior # of Bouts Junior Olympic # of Bouts Master # of Bouts (Please indicate the number of bouts by age.)

Will women be boxing in this event? Yes No ( If yes, please indicate the number of bouts by age)

Level of Competition Senior # of Bouts Junior Olympic # of Bouts Master # of Bouts

Official in Charge of Event

Ringside Physician(s) Name(s) Volunteer Physician(s)  Paid Physician(s) 

I agree to comply with conditions as listed on the reverse side of this form and USA Boxing’s Rules and Policies

Applicant’s Signature Date

For Local Boxing Committee Use Only

Approved/Rejected (Circle One) Signed Date LBC President or Designee LBC Name Sanction Number

Rev 6/2009

Jurisdiction 1. All competitions of any kind where athletes compete, demonstrate or display talents or technique must be sanctioned except those in which participation is restricted to a specific class of amateur athletes within the meaning of section 206 of the Ted Stevens Olympic and Amateur Sports Act and revisions. 2. The word “Olympic” cannot be used without special permission. 3. USA Boxing, its officers, directors and Local Boxing Committees shall be held harmless from any liability arising out of claims for damages for injuries. 4. Entry blanks and prizes must receive prior approval from Local Boxing Committee.

Prize Limitations No prizes shall be given to any individual, club, committee, or association, or competed for, or accepted by any athlete, except of a lasting nature intended for the athlete. The said prizes shall not exceed the cost of $100 for first, $40 for second, $20 for third, unless challenge trophies or other similar prizes are authorized by special permission of USA Boxing and a record kept of such authorization. Suitable team and individual prizes may be awarded for team competitions.

Conditions 1. Sanctions will not be issued to organizations whose interest in sports and games is commercial, or that are for profit organizations. Sanctions may not be transferred. Sanctions may not be issued to individuals. 2. No sanction will be given to organizations, which have failed to fulfill expense obligations to athletes or to give prizes as stated on its entry. 3. All bouts must be officiated by certified USA Boxing officials (judges, referees, coaches, timers, and clerks, etc.) bout cards shall, at all times, be in the possession of the LBC President and/or designee, and retained by the LBC for one year. 4. Sanctioned boxing comes under the exclusive jurisdiction of the said LBC/Association of USA Boxing. 5. Boxer’s entry will not be accepted, nor will he/she be allowed to compete unless he/she is registered with USA Boxing and presents a current passbook and signed entry form. 6. Entry information, advertising and program must bear the statement “Sanctioned by______LBC/ Association and USA Boxing” and the sanction number. 7. All rules and regulations of the said LBC/Association and USA Boxing will be complied with. 8. Failure to comply full with this sanction will cause immediate and direct withdrawal of said sanction. 9. Sanctioned boxing must adhere to the rules and guidelines of the California State Athletic Commission.

“A copy of this sanction must be displayed in the weigh-in room or other conspicuous place”