USAW WEIGHTLIFTING COACHING COURSE SANCTION FORM (4/19/13)

PLEASE SEE THE ‘HOW TO HOST A COURSE’ PAGE FOR IMPORTANT INFORMATION:

I, ______, as the coordinator, apply on behalf of ______

(Please print name) (Organization)

for a sanction to hold a (an) ___ Weightlifting and Sports Performance Coach Course

___Advanced Weightlifting and Sports Performance Coach Course

Phone (H) ______(W) ______(C) ______
(Please circle the # we should use in course listing)

E-mail we should use for the course listing ______

In applying for this sanction, I am agreeing to assure that the following conditions are met:

1 - Facility Size – a 10’x 10’of open, flat and level floor space (and/or platform space) per 4 (or fraction thereof) number of participants (e.g., four 10’ x 10’ areas for 18 participants)

2 - Safety- Meets all local fire safety standards, such as for safe means of egress, in case of danger. Emergency evacuation plan for any instructor or participant in need of immediate medical attention.

3 - Equipment - Chairs and tables for each participant for exam taking and any lectures

One Olympic-style weightlifting bar, one 1”wooden dowel or PVC pipe, and at least one set of bumper plates for each 4 participants.

4 - Agency Presence and Exclusivity - A representative of the hosting facility available throughout the course and there will be no other event occurring concurrent with the course, unless there is a clear delineation of venues and programs.

Coaching course sanctions must be submitted to the National Office at least (8) eight weeks before the start date of the course.

Please make sure that the dates requested don’t coincide with our national event dates, as many of our instructors are also coaches.

Any changes (Host, facility, dates, instructors) that require edits to be made to the original application will incur a $50 ‘reprocessing’ fee.

Coordinator’s Signature ______Date ______

Name of Course Facility ______
Address______

City ______State ______Zip______

Dates of Course: 1st Choice______2nd Choice______
Max # participants the facility can handle______(Capping the Course. The host is entrusted with ensuring the quality of the experience for each participant and should keep the number of participants to an appropriate level. Please select the cap number carefully as any request to change the cap will result in a $50 ‘course edit’ fee

Name of Instructor (must be one approved by the National Office):______

(Please print name)

Instructor’s Phone (H) ______(W) ______(C) ______

Instructor’s E-mail ______
There must be an instructor at the course for every 10-15 participants.
Mail To: USA Weightlifting OR Fax To: 719-866-4741

1 Olympic Plaza ORE-mail to:

Colorado Springs, CO 80909