SANCTION & APPROVAL REQUEST FORM MINNESOTA SWIMMING USA SWIMMING, INC. Revised 12/2012

Date:

I, , apply on behalf of for a sanction to hold at on

Our sanction fee, a copy of the meet information, entry form and the order of events are attached.

The meet information must follow the directions given from the Sanction Officer for your particular meet. There are meet templates for all MSI scheduled weekend meets and for non-scheduled meets.

As a condition of obtaining such a sanction, I and the above organization, which I represent, agree to abide and govern this event under the rules and regulations of USA Swimming, Inc. and Minnesota Swimming, Inc. and all other terms and conditions upon which this sanction my be granted. These terms specifically include all local rules and regulations and those set forth in Article 202 of the current addition of USA Swimming Rules and Regulations, specific reference to Paragraph Two of Article 202 thereof, which provides that:

In granting this sanction it is understood and agreed that USA Swimming, Inc. and Minnesota Swimming, Inc. shall be free from any liabilities or claims for damages arising by reason of injuries to anyone during the conduct of the event.

Meet Director Name and Email: Name of Club: Address:

Sanction Fees: Scheduled bid meets – includes bid invitational meets: $100.00 – 90 days prior to meet date $150.00 – 60-89 days prior to meet date $200.00 – 30-59 days prior to meet date

Non-scheduled meets $100.00 (must be submitted at least 30 days prior to the first day of the meet) Passed November, 27, 2012 Board of Directors meeting Approval - $100.00 (must be submitted at least 30 days prior to the first day of the meet) Passed November, 27, 2012 Board of Directors meeting

Email this application along with your meet information to: [email protected] Send a check for the sanction fee as listed above to: MSI, 1001 Highway #7, Suite 250, Hopkins, MN 55305

Amount of check:______Check # ______By: ______Date: ______

Sanctioned _____ Approved ______Not Sanctioned or Approved _____ Date Issued______

Sanction Number ______Signed ______

Time Trial Number ______Signed ______

Approval Number ______Signed ______