SAVOA Membership Application

Membership Application Type*

If Dual, select Primary Chapter

If Transfer, state previous Chapter

TASO ID Number

Full Name*

First NameMiddle NameLast Name

Date of Birth*

Date

Gender

FemaleMale

Home Phone

Please enter a valid phone number.Format: (000) 000-0000.

Mobile Phone*

Please enter a valid phone number.Format: (000) 000-0000.

Work Phone

Please enter a valid phone number.Format: (000) 000-0000.

Mailing Address*

Street Address

Street Address Line 2

CityState / ProvincePostal / Zip CodeCountry

Email Address*

example@example.com

Additional Applicant Information

Herein, San Antonio Volleyball Officials Association is referred to as, “Chapter”, “SAVOA”. Please read carefully: I understand and agree that: 1. Membership in the Chapter and/or TASO does not guarantee game assignments. 2. I am responsible for informing the Secretary of any changes to my contact information as well as any change to my officiating availability/restrictions. 3. I will pay any applicable fee for canceling a game once I have accepted the game assignment. 4. TASO will provide accident insurance only for injuries sustained/arising from my officiating assignments subject to deductible and other policy limitations. 5. In accepting game assignments from the Chapter, I am acting as an independent contractor and as such, I am subject to being video/audio recorded and/or photographed. 6. I release all liability and hold harmless the Chapter, for the use of my likeness, and will not seek any form of compensation. 7. I will comply with the TASO and Chapter Policies. 8. All game assignments received through the Chapter are subject to revocation, cancellation or reassignment in the event I cease to be a member in good standing, or if it is in the best interest of the Chapter and/or TASO that the game be revoked, cancelled or reassigned. 9. I will file all required game reports as required by the Chapter and/or TASO and pay any applicable game fees, fines or assessments. 10. Except as listed on the attached sheet or as previously disclosed and ruled on by the Disciplinary Appeals Committee, I certify that, except for minor traffic offenses punishable by fine only, I have not ( a) been convicted of a state or federal misdemeanor or felony offense, (b) been arrested on a pending state or federal misdemeanor or felony charge, or (3) received deferred adjudication or other deferred sentencing for a state or federal misdemeanor or felony offense. 11. I certify that this information is true and correct and I understand that TASO may verify all or any portion of this report (from TASO app. Rev. 08-2011). 12. I agree to abide by all SAVOA by-laws and operating procedures. Please read and agree to the membership terms and conditions listed below.

Signature*

Date*

Date

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