Sanction Request Form

This form must be completed in full a minimum of 30 days prior to the event

Name of requesting Association, Organization or Team:

Title of Event:

Location of the Event

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Main Contact:

First NameLast Name

E-mail

example@example.com

Phone Number

Area CodePhone Number

Not for profit association:

YesNo

Description of event:

Age categories:

Genders included:

MaleFemaleAll

Is the event inclusive to any players within appropriate designated age levels?

YesNo

Do you agree to abide by FNB's Safety Policy?

YesNo

Do you agree to abide by FNB's Screening policy and Safe Sport policies?

YesNo

Do you require insurance?

YesNo

If no, please provide a copy of your insurance.

Describe how your event aligns with the Long Term Athlete Development Model (LTAD)

Date(s) and Time(s) of Event:

Please provide a list of coaches who will be participating along with their NCCP number. All coaches must have a minimum of Safe Contact and Safe Sport..

	Name	NCCP Number	Team/Club
Coach #1
Coach #2
Coach #3
Coach #4
Coach #5
Coach #6
Coach #7
Coach #8
Coach #9
Coach #10
Coach #11
Coach #12
Coach #13
Coach #14
Coach #15

I acknowledge that I have read and understood the FNB sanctioning guidelines. Ihereby agree to and understand the guidelines as previously stated in the FNBSanctioning Policy.

AgreeDisagree

Once submitted FNB will be in touch if they require any additional information.