Your Information
= Required Field
First and Last Name
Title or Position
Team / Club
(select one)
Other Team/Club
Adair Swim Association (ASA) Arkansas City Manta Rays (ARK) Atchison YMCA Swim Club (ATCH) Belton Swim Team (BELT) Blue Springs Swim Parents Club (BSS) Blue Wave Swim Team (BWST) Bonner Springs Swim Club (BSSC) Boonville Marlins (BVMR) Brooktree Swim Team (BTST) Burlington Aquatics Club (BAC) Butler Torpedoes (BTT) Cass County Aquatics (CCA) Chisholm Trail Swim League (CTSL) City of Mission Swim Team (CMSC) ClayPlatte YMCA Blue Wave (CPYM) Clayview Country Club (CL) Columbia Aquatics (CA) Columbia Swim Club (CSC) Community Of Olathe Swim Club (COOL) Country Club Of Blue Springs (CCBS) Coves Swim Team (CO) Derby Swim Club (DSC) El Dorado Swim Club (EDSC) Emporia Aquatic Club (EAC) Fort Leavenworth Lancers (FTLL) Golden Valley Swim Club (GVSC) Grand River YMCA Gators (GRYG) Great Plains Swim League (GPSL) Harrisonville Aquacats (HST) Haysville Summer Swim Club (HVSS) Haysville Swim Club (HVSC) Hills Of Waldon Swim Team (HWH) Homestead Country Club Swim Team (HCC) Hutchinson Y Swim Club (HYSC) Jasper County Aquatics (JCA) Jasper County Killer Whales (JCKW) Jefferson City Area YMCA (JCAY) Jewish Community Center Jets (JCC) Kansas City Blazers (KCB) Kansas City Storm (KCST) Kansas City Swim Academy (SA) Kansas Swimming (KS) Kaw Valley Swim League (KVSL) Kaw Valley Swimming Tortugas (KVS) Kearney Swim Club (KSC) Kirksville Tigersharks (KTS) Lawrence Aquahawks (LAW) Leawood Country Club Swim Team (LCC) Leawood Lightning Swim Team (LST) Liberty Hills Country Club (LHCC) Loch Lloyd Country Club (LLCC) Louisburg Swim Club (LBSC) Manhattan Marlins (MM) McPherson Swim Club (MSC) Meadowbrook Country Club (MCC) Mid America League (MAL) Mid-America Swim Parents Assoc (MASP) Mid-Missouri Aquatic Club (MMAC) Missouri Athletic Center Swimming (MAC) Missouri State Aquatics (MSA) Missouri Swim Stars (STRS) MIZZOU (MIZ) MIZZOU Swim Team (MIZZ) Mo. So. St. College Sea Lions (MSSC) Mo-Kan Swim League (MOKA) New Mark Swim Team (NM) Nicklaus Golf Club Swim Team (NGCS) Northland Swim & Dive Conf (NSC) Northland United Swim Team (NLU) Northwest Swim Team (NWST) Oak Grove Swim Club (OGSC) Olathe Aquatic Association (OLA) Old Pike Country Club Swim Tm (OP) Ottawa Swim Club (OTT) Paola Swim Club (PSC) Parsons Dolphins (PARS) Pittsburg YMCA Swim Team (PITT) Pleasant Hill Dolphins (PHD) Pony Express Swim Team (PEST) Raytown Riptide (RR) Red Bridge YMCA (RBY) Riss Lake Swim Team (RISS) Salina Aquatics Club (SAC) Salt Fork Manta Rays (SFY) Santa Fe Trail Blazers Parents (TRB) Sherwood Swim Team (SH) South Suburban Swim League (SSSL) Southwest Missouri Otters (SWMO) Southwest Missouri State Univ (SMSU) Spirit of Kansas City (KCSP) Springfield Aquatics (SPA) Stingrays (STRY) Suburban Municipal Swim League (SMSL) Swim Harrisonville (SWHR) Swim Independence (SI) Swim Newton (NWSC) Team Dolphins (TD) Thousand Oaks Swim Team (TOST) Tiger Shark Swim Team Club (TSS) Topeka Swim Association (TSA) Topeka Team Torpedo (T3) Trident's Swim Team (WACT) Truman Aquatics (TRMN) Tsunami Swim Team of K.C. (TST) Twin River Club (TRC) University Of Kansas (KU) Valley Center Purple Wave (VCSC) Walnut Creek Swim Team (WC) Wamego Swim Team (WAM) Warrensburg Swim Team (WRN) Wellington Swim Team (WELL) West Wichita YMCA Barracudas (WWYB) Western Kansas Swim Club (WKSC) Wichita Aqua Shocks (WAS) Wichita Northwest Y Neptunes (WNYN) Wichita Swim Club (WSC) Winfield Swim Club (WIN) Woodside Racquet Swim Team (WRST) YMCA Swim Fins (FINS)
Daytime Phone
Evening Phone
Fax Number
Email Address
Where sanction should be returned
Club President
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. Your file MUST be placed in a ZIP file for it to be forwarded correctly.
Attached 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 also be sent to the MVS Treasurer before a sanction will be granted.