Name of Event: ________________________________________________________________

Event Type: ________________________(League, Tournament, Camp, Training, Other event)

Hosting Organization: ______________________________Website URL: ________________

Contact Person: ___________________________Address: _____________________________

City, State and Zip: _____________________________Email: _________________________

Contact Phone Number: _________________Alternate Phone: __________________________

Location of Event: ________________________________# of Fields/Buildings: ___________

Describe event/attach game rules if applicable: _______________________________________

Will awards/prizes be given: Yes or No (circle one) Type: _____________________________

Age Groups of participants: ___________________ Gender: ___________________________

Begin Date of Event: ___________________ End Date of Event: _______________________

Below, describe Event Times, i.e., (Every Tuesday and Thursday from 5-7 pm) etc.

____________________________________________________________________________

It is understood and agreed that the above hosting organization will be an Associate of NMYSA and identified as such on the NMYSA website at www.nmysa.net. Associate members must abide by NMYSA, US Youth Soccer and USSF rules as they pertain to risk management, referees and player/coach registration. Participating Players/Coaches must be registered members of NMYSA. Event officials must be able to verify registered members by presentation of the current Player/Coach NMYSA pass card or roster. All event administrators must have a current NMYSA Risk Management Clearance.

___________________________________ _________________________________

Signature of Hosting Official Signature of NMYSA Official

Date: _____________________________ Date: ____________________________

NMYSA Associate Member Sanction Fees:

One time Camp fees, up to two weeks $5.00 per player

Seasonal Camp fees, over two weeks not more than 10 weeks $7.00 per player

Annual fees, over 10 weeks, program runs at various times annually $12.00 Per player

League play, 10 or under games Per Team

(See Below)

Tournaments Per Team

(See Below)

League Sanctioning Fees and Tournament Sanctioning fees are based on the number of players allowed for each side on the field. See below for example.

3v3 - sanctioning fees are $13.00 per team

4v4 – sanctioning fees are $14.00 per team

5v5 – sanctioning fees are $15.00 per team

6v6 – sanctioning fees are $16.00 per team

7v7 – sanctioning fees are $17.00 per team

8v8 – sanctioning fees are $18.00 per team

9v9 – sanctioning fees are $19.00 per team

11v11 – sanctioning fees are $21.00 per team

Associate member must provide a list of participating teams/players and pay the sanctioning fees within 30 days after the event or at conclusion of each seasonal event for annual associate events.

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