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Promotion Name:
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Contact Name:
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Address:
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City:
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ST:
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Zip:
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Primary Phone:
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Public?
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Fax:
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Email:
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Webpage URL:
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Requested Date:
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Day of Week:
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Venue Name, Address, City, St, and Contact
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Seating Capacity:
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Number of potential bouts
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How many events have
you promoted?
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Requested Officials:
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Event Representative
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Lead Referee
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Second Referee (req'd for over 15 bouts)
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Judges
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Timekeeper
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The previous selections are requests. CSC will assign all officials on CSC sanctioned events.
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Physician Information.
Include Name, City, ST, Phone and if available Email. Also include the doctors specialty (MD, DO, etc)
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Ring Announcer Name and Phone Number:
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Your EMS and Ambulance Service
Include Service Name, City, St, Contact Person, Phone and email if available
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Is EMS and Ambulance already scheduled?
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How will you handle your Fighter Medical Insurance Coverage?
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If CSC will be assisting you with this insurance, you will be contacted for more information.
Medical Coverage is PER BOUT and must be a minimum of $5000 medical / $5000 accidental death / $500 deductible for up to 10 Bouts, $100.00 for each bout after.
If you are providing your own insurance, CSC will be named on the policy along with the protion company and the promoter personally.
It must be for the proper amount of projected bouts.
AND, it must be submitted 7 days prior to the event to bwick@combatsportscommission.com your agent can email it directly to us..
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How will you handle your VENUE LIABILITY Insurance Coverage?
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If CSC will be assisting you with this insurance, you will be contacted for more information.
You will be required to fill out an application. It must be returned promptly to insure coverage.
Liabilty Coverage is PER EVENT / PER DAY and must be a minimum of 1 million per occurrence / 2 million gross aggregate.
If you are providing your own insurance, CSC will be named on the policy along with the protion company and the promoter personally.
It must be for the proper amount of projected Date and number of Days, AND, it must be submitted 7 days prior to the event to bwick@combatsportscommission.com your agent
can email it directly to us..
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ALL of the following questions / statements must be answered for this form to be processed. If you can not answer them,
please email your concerns to Admin@combatsportscommission.com.
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Have you ever been convicted of a Felony?
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I have read and agree to all requirements of sanctioning.
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I agree to submit all applicable fees according to the guidleines
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Will this event be televised live or recorded for later replay?
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I understand the following conditions and requirements
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I Agree
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All print Ads, Posters, Flyers, & Event Programs are required to have an
approved CSC logo and the words "sanctioned by Combat Sports
Commission" placed within the document. GET LOGOS HERE
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All Audio and or Video advertisements are required to include the
message "This event is sanctioned by Combat Sports Commission
under the authority of the Missouri State Office of Athletics, for more info
go to www.combatsportscommission.com". Spoken or written form are
acceptable for either application.
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A complete video copy of the event must be recorded and is the
Promoters responsibility.
A copy MUST be delivered to the CSC offices no later than 10 days after
the event and will be placed in your event file. VHS or DVD are
acceptable formats.
This is a requirement of the Missouri Office of Athletics and is not
optional.
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As part of this sanctioning agreement, if you are called upon by the
Missouri Office of Athletics to appear in person, you agree. Further, you
agree to answer any questions that may arise as part of any
investigation or inquiry by the Office of Athletics.
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Event Matchmaker
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Phone
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The above matchmaker has read and understands the matchmaking
criteria and agrees to abide by those standards. Furthermore, The
matchmaker agrees to utilize the Bout Agreement Forms found under forms
on this website, and submit those forms to the event representative at
weigh-ins.
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By using the electronic signature below, the promoter listed within agrees to the terms and conditions of this contract and
all statements herein are true to the best of their knowledge.
Electronic signature format: Last name and Zip Code (eg; Cook65240)
We will also have your IP address as a verifiable identification.
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Printed Full Name
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Electronic Signature
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You will be instructed about payments on the next page.
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