Your Information
= Required Field
First and Last Name
Title or Position
Team / Club
(select one)
Other Club (not listed below)
Ad Astra Area Aquatics (AAAA) Adair Swim Association (ASA) Andover YMCA All Stars (ANDR) Arkansas City Manta Rays (ARK) Atchison YMCA Swim Club (ATCH) Bonner Springs Swim Club (BSSC) Brooktree Swim Team (BTST) Burlington Aquatics Club (BAC) Clayview Country Club (CL) Club North Swimming (CNS) Columbia Swim Club (CSC) COOL Swim Team (COOL) Coves Swim Team (CO) Derby Swim Club (DSC) El Dorado Swim Club (EDSC) Emporia Aquatic Club (EAC) Fort Leavenworth Lancers (FTLL) Grand River YMCA Gators (GRYG) Haysville Swim Club (HVSC) Heart Of America Swim Club (HASC) Hills Of Waldon Swim Team (HWH) Hutchinson Y Swim Club (HYSC) Jefferson City Area YMCA (JCAY) Kansas Aquatics (KA) Kansas City Aquatics Club (KCAC) Kansas City Blazers (KCB) Kansas City Storm (KCST) Kansas City Swim Academy (KCSA) Kaw Valley Swimmers (KVS) KC Blue Wave Swim Team (BWST) Lawrence Aquahawks (LA) Manhattan Marlins (MM) McPherson Swim Club (MSC) Miami County Vipers (MCV) Mid-Missouri Aquatic Club (MMAC) Missouri State Aquatics (MSA) New Mark Swim Team (NM) Northland United Swim Team (NLU) Old Pike Country Club Swim Team (OP) Parsons Dolphins (PARS) Pony Express Swim Team (PEST) Raytown Riptide (RR) Riss Lake Swim Team (RISS) Salina Aquatics Club (SAC) Sherwood Swim Team (SH) Swim Harrisonville (SWHR) Swim Newton (NWSC) Team Dolphins (TD) Thousand Oaks Swim Team (TOST) Tiger Shark Swim Team (TSS) Topeka Swim Association (TSA) Trident's Swim Team (WACT) Tsunami Swim Team of KC (TST) Twin River Club (TRC) University of Missouri (UMIZ) Valley Center Swim Club (VCSC) Walnut Creek Swim Team (WC) Warrensburg Swim Team (WAR) Wellington Swim Team (WELL) West Wichita YMCA Barracudas (WWYB) Western Kansas Swim Club (WKSC) Wichita Aqua Shocks (WAS) Wichita Northwest YMCA Neptunes (WNYN) Wichita Swim Club (WSC) Winfield Swim Club (WIN)
Daytime Phone
Evening Phone
Fax Number
Email Address
Where sanction should be returned
Club President
or Contact
Address
City and State
Zip Code
Meet Information
Name of Meet
Name of Pool
(or facility)
Location of Meet
(city and state)
Start Date
(mm/dd/yy)
End Date
(mm/dd/yy)
Meet Referee
Meet Starter
(may be a Starter Trainee)
Additional Comments
Attach your meet information using the space below.
Attach Meet File
By submitting this form, I am applying on behalf of my swim club/organization for a sanction to hold swimming competitions at the pool listed above and on the dates shown.
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 Missouri Valley Swimming, Inc. and all other terms and conditions upon which this sanction may be granted. These terms specifically include all local rules and regulations and those set forth in the current edition of the USA Swimming Code, with specific reference to Article 202.4.4 §4 which provides
that:
"USA Swimming, Inc. and Missouri Valley Swimming, Inc. shall be held free and harmless from all liabilities or claims for damages arising by reason of injuries to anyone during the conduct of this meet."
Officials for this meet shall be qualified persons as certified by USA Swimming, Inc., and the meet referee, who has agreed to serve, must be shown on the "Meet Rules / Information" sheet.
A $15 Application Fee must be sent to the MVS Treasurer before a sanction will be granted.