APPLICATION FORM - INTERNATIONAL TEAM OFFICIAL LICENCE 
 2013

FEDERATION

Name: 	Climbing Federation of Russia	Country: RUS

Address:  119991, 242a, 8, Luzhnetskaya nab., Moscow

COMPETITOR

Surname:	Sergeev	Given Name:	Sergei
Sex:	male	Date of Birth (d/m/y):	1956-01-01
Address:	Melnikayte st., 00 - 00
	…………………………………………… 
City:	625000 Tyumen	Country:	RUS
Cell / Mobile Tel.: +79120000000	Other Tel.	+73450000000
(with international code)
 E-mail:	s_s_s0000@mail.ru

I. Obligations of Team Officials

By applying for an International Licence I acknowledge the rules of IFSC and commit myself to act according to these rules.

In particular:

•	I understand and abide by the regulations and rules of the sport and observe the principles of good sportsmanship;
•	I will accept, subject to the official appeal procedure, the decisions of the official judges without question or protestation and exercise self-restraint at all times;
•	I will refrain from facilitating, providing and encouraging others to use prohibited substances and methods (Refer Footnote 1) as well as transporting the above substances;
•	I will treat other Team officials, Athletes, Officials and others involved in the practice of the sport with full and due respect at all times, both during and outside a competition.
•	I will not be involved in betting in respect of IFSC competitions and will comply with the IFSC Code of Conduct on Sports Betting Integrity

In connection with anti-doping: 

•	I expressly acknowledge the right of WADA and any other anti-doping organisation to perform out-of-competition tests on Athletes I may be in charge of on behalf of the IFSC;
•	I expressly acknowledge the right of IFSC and WADA to start or to join as a party in disciplinary proceedings in connection with any disciplinary offence (including involvement in doping cases) against me.

I agree that the IFSC may:

•	publish any disciplinary or appeal decision concerning me (including on its website).
•	record my image by any types of equipment (video, photo etc.) and use it for any purpose in relation to and in connection with the interests of sports climbing. 
•	Use my e-mail address to send me the IFSC newsletter and other IFSC related information

Footnote N°1: Reference is the latest available List of Prohibited Substances and Methods published by the WADA : http://www.wada-ama.org/en/Science-Medicine/Prohibited-List/ 

I have read and agree to the IFSC Code of Conduct on Sports Betting Integrity

Team Official’s signature: ...................................................................	Date:............................ 
Federation’s Seal: ……………………………………

II. Obligations of IFSC Member Association

A Member Association whose Team Official apply for an International Licence undertakes:

•	to inform the IFSC immediately of any change of the Team Official details given above;
•	to inform the IFSC immediately of any disciplinary proceedings against the Team Official;
•	to start on request of IFSC without delay disciplinary proceedings against any Team Official who has been involved in any doping case or illegal betting case and to keep the IFSC fully informed about the progress of any such proceedings.

………………….					……………………………………
(Place and date)				(Seal of the Federation and readable Signature )     

IMPORTANT NOTICE

All Team Official wishing to perform their duty in International Climbing competitions must be in possession of an International Licence issued by the IFSC.

Those Team Official for whom their belonging Federations have not applied for an International Licences and who are not registered for the relevant competition, will NOT be allowed to perform the following duties in IFSC approved events: 
-	Submit appeals
-	Access isolation zone, Team Official zone and other restricted areas of the Field of Play

In addition and in case of, no free access to the competition venue will be granted to non-registered Team Officials.

Validity of each licence expires at the end of the current calendar year. 

Each year, before the first competition of the season (or before the first competition of the season in which their Team Officials intend to perform their duty), every Federation shall apply for new licences or for renewal of existing ones, all in written and using this form.
Forms without the seal and the signature of the applying Federation and of the Team Official shall not be taken into consideration. 

Therefore,

Forms shall be sent by post only in original (ALL pages), duly sealed and undersigned by the Federation’s officer in charge and the Team Official, reporting the dates when it was signed.
Forms sent by e-mail and/or fax will be considered as a unofficial pre-registration.
Each Form is to be used for ONE Team Official Only

2013 - Annual licence fee cost 30 €/ Team Official, for both new and renewed licences. These fees are to be paid upon receiving the relevant invoice, at the end of the season.
No registration fees to the competitions will be applied.