Click the box next to each varsity sport/activity your school sponsors. Indicate the number of participants at your school. If sending full or partial payment, enter amount in appropriate box. SAVE the form on your computer as "schoolname-membership.xls" (e.g., ParkViewSterling-membership.xls PRINT the form. Affix a

MEMBERSHIP APPLICATION FOR THE SCHOOL YEAR 2020-2021 ..- Mail completed application with applicable fees to VHSL, 1642 State Farm Blvd., Charlottesville, VA 22911

n?""�d:;e complete this application and return it with your remittance to the League office by August 1, 2020. If your school division pays your membership fee, complete the application and forward it to your school division. Ask them to include your completed application with their payment, and send both the application and payment to the League office by August 1, 2020. Partial payment of your membership fee is permitted provided you have received written approval for such payment from the Executive Director, and the complete payment is made on or before September 15, 2020 (9-2-2, VHSL Handbook). Your 2020-21 membership fee is $800 plus $35 for each varsity activity marked below that your school sponsored during the 2019-20 school year. Similarly, the insurance premium is also based on your school's total number of participants from the 2019-20 school year. The insurance formula used in prior years of counting only athletes and cheerleaders, with each person counted just once regardless of the number of sports he/she plays, remains in effect. If you are aware that a listed varsity activity will be added to or deleted from those sponsored during the 2020-21 school year, you may incorporate those changes into this application. For any new sports, the additional insurance premium due should be based on the number of participants anticipated to be on the team. This completed application serves as your invoice. No further billings will be sent by the VHSL. (Girls} Soccer (Girls} Debate (Boys) (Girls} Film Festival Basketball (Girls) Indoor Track (Boys) Swim/Diving (Boys) Forensics Indoor Track (Girls) Swim/Diving (Girls) Scholastic Bowl Cross Country (Boys) (Boys) (Boys) Student Media (Publications) Cross Country (Girls} Lacrosse (Girls} Tennis (Girls) Theatre Festival Outdoor Track (Boys) (Boys) Football Outdoor Track (Girls} Volleyball (Girls} Golf (Boys) Soccer (Boys) Enter number of sponsored activities: 22 X $35 = $770.00 1 Basic Membership Fee: $800.00 League lnsurance Premium: (Enter # of participa nts here) e I 937 I Students x $5.50 each = $5,153.50 TOTAL DUE IF PAID BY AUGUST 1, 2020: $6,723.50 Enter amount enclosed here e Balance Due: 6723.50

If paid AFTER August 1, 2020, amount due is (10% late fee): $ 7,395.85 Amount enclosed (if afterAugust 1 ): I I Balance Due: $7,395.85 Payment for the total amount is due in the League office on or before August 1, 2020, unless you have received an extension from the Executive Director or the Chief Financial Officer.

As principal of Brooke Point High School High School, and with the expressed written authority from my school board, I am applying for membership in the High School League, Inc., for the school year 2020-2021. Our current classification is: Class 5 Region o As the representative for this school, I agree to uphold and abide by the League's by-laws, and all rules, regulations and policies, and will instruct and co el all sc ol r;iersonnelto comply with all League rules, regulations and policies. ,- Signed: Principal Date: -,S/ ·:z /J 1..0 (Signa ure Required) / f

We certify that Brooke Point High School applies for VHSL membership with the expressed written authority of its school board and with the understanding that the high school subscribes to and agrees to follow the rules of eligibility, and all other rules, regulations and policies of the League. The Superintendent has given permission for Sunday play in emergency sltuatlons,

Signed: _____ ..,.,..,.:--:---::.-...... ,...... ,.,...----- School Board Chairperson (Signature Required) Date

Signed: _____ ...".,.,:--...,...--:'_.,....-:-- Superintendent (Signature Re!,!uired) Date