Move United 2021 Sanctioning Application

Chapter Name*

Other Chapter Name (not listed above)

Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Event Director Name*

First Last

Event Director Email*

Event Director Phone Number*

Event Director's Address (if different than the organization)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Is the Event Director also the main point of contact?*

Yes
No

Event Website

Social Media Handle(s)

Event Name*

Event Location (City, State)*

Event Start Date

Event End Date

Are these dates:

Firm Dates
Tentative Dates

Registration Open Date

Registration End Date

Do you plan to hold your event:*

In person
Virtual
Combination (in person and online)

If your event cannot be held in person (due to COVID-19) would you move to an on-line event?*

Yes
No
Would consider it with some guidance.

If you hold an in-person or combination in-person/virtual event, do you agree to have a written COVID-19 plan in place?*

Yes
No

Point of Contact Name (if different than Event Director)

First Last

Point of Contact Email (if different than Event Director)

Point of Contact Phone (if different than Event Director)

Secondary Event Contact Name (if applicable)

First Last

Secondary Event Contact Email (if applicable)

Secondary Event Contact Phone (if applicable)

Third Event Contact Name (if applicable)

First Last

Third Event Contact Email (if applicable)

Third Event Contact Phone (if applicable)

Estimated Budget*

Please list main sponsors for this event.

Upload sponsor packet or provide a link below.

Drop files here or

If unable to upload, provide a link to sponsor packet.

Upload Event Logo

Sanctioned Sports

Will you be offering Archery?

Yes
No

Facility Name

Facility Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Level Requesting

If sanctioned by another governing body, please list:

Head Archery Judge

First Last

Head Archery Judge's Email

Head Archery Judge's Phone

Will you be offering Powerlifting?

Yes
No

Facility Name

Facility Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Level Requesting

If sanctioned by another governing body, please list:

Head Powerlifting Referee

First Last

Head Powerlifting Referee's Email

Head Powerlifting Referee's Phone

Will you be offering Shooting (airgun)?

Yes
No

Name of Facility

Address of Facility

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Level Requesting

If sanctioned by another governing body, please list:

Head Shooting Judge

First Last

Head Shooting Judge's Email

Head Shooting Judge's Phone

Will you be offering Swimming?

Yes
No

Name of Pool

Address of Pool

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Level Requesting

If sanctioned by another governing body, please list:

Head Swimming Official

First Last

Head Swimming Official's Email

Head Swimming Official's Phone

Will you be offering Table Tennis?

Yes
No

Name of Facility

Address of Facility

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Level Requesting

If sanctioned by another governing body, please list:

Head Table Tennis Official

First Last

Head Table Tennis Official's Email

Head Table Tennis Official's Phone

Will you be offering Track & Field?

Yes
No

Name of Venue

Address of Venue

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Name of 2nd Venue (if applicable)

Address of 2nd Venue (if applicable)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Level Requesting

Is this sanctioned by another governing body?

USATF Sanctioned
WPA Approved
WPA Sanctioned through US Paralympics Track & Field

Head Track & Field Official

First Last

Head Track & Field Official's Email

Head Track & Field Official's Phone

Other Sports Offered

What other Paralympic sports are offered as a COMPETITION during this event? (Check all that apply or list below)

Other Competition Sport 1

Other Competition Sport 2

Other Competition Sport 3

What other Paralympic sports are offered as a CLINIC during this event? (Check all that apply or list below)

Other Clinic Sport 1

Other Clinic Sport 2

Other Clinic Sport 3

What other Paralympic sports are you interested in offering, but do not currently offer? (Check all that apply or list below)

Other Interest Sport 1

Other Interest Sport 2

Other Interest Sport 3

#AdaptatHome COVID-19 Updates

Move United 2021 Sanctioning Application

2021 Move United Sanctioning Application

Sanctioned Sports

Other Sports Offered

Ability360 Sports & Fitness Center
Ability First Sports
AbilityPLUS, Inc.
ACCESS of Wilmington
AccesSportAmerica
AccesSurf, Hawaii Inc.
Achieve Tahoe
Adaptive Action Sports
Adaptive Adventures
Adaptive Expeditions
Adaptive Outdoor Education Center
Adaptive Sports and Recreation Association (ASRA)
Adaptive Sports Association
Adaptive Sports at Mount Snow
Adaptive Sports Center of Crested Butte
Adaptive Sports Connection
Adaptive Sports Foundation
Adaptive Sports IOWA
Adaptive Sports New England
Adaptive Sports Northwest
Adaptive Sports Partners of the North Country
Adaptive Sports Program - Helen Hayes Hospital
Adaptive Sports Program New Mexico
Adaptive Sports Program of Ohio
Adaptive Wilderness Sports Of McCall (AWeSOMe!)
Adventure Amputee Camp Inc
Adventures Without Limits
Angel City Sports
AquAbility, Inc.
Arizona Adaptive Watersports
Arizona Disabled Sports
Baltimore Adaptive Recreation and Sports
Bart J. Ruggiere Adaptive Sports Ctr, Inc.
Bay Area Association of Disabled Sailors
Bay Area Outreach and Recreation Program
Bay Area Volleyball Academy - BAVA Beach ParaVolleyball
Bennett Institute Physically Challenged Sports of Kennedy Krieger
BlazeSports America
Blue Ridge Adaptive Snow Sports (BRASS)
Boise Adaptive Snowsport Education (BASE)
Breckenridge Outdoor Education Center (BOEC)
Bridge II Sports
Burke Rehabilitation Hospital Adaptive Sports Program
Cannonsburg Challenged Ski Association
Capital Region Nordic Alliance (CRNA)
Central California Adaptive Sports Center
Central Florida Dreamplex, LLC
Central Maine Adaptive Sports
Central Vermont Pioneers Inc.
Challenge Alaska
Challenge Aspen
Challenged Athletes of West Virginia
Challenge Foundation
Charles T. Sitrin Health Care Center, Inc.
Chesapeake Region Accessible Boating (CRAB)
Children's Lightning Wheels
City of Reno
Clemson Adaptive Sports
Coastal Adaptive Sports
Colorado Discover Ability
Common Ground Outdoor Adventures
ComMotion - Community in Motion
Courage Kenny Rehabilitation Institute
Crotched Mountain Accessible Recreation and Sports
Dairyland Sports
Dare2Tri Paratriathlon Club
Disabled Athlete Sports Association (DASA)
Disabled Sports Eastern Sierra
Dixie Wheelchair Athletic Association, Inc.
DREAM Adaptive Recreation
DSUSA Los Angeles - The Unrecables
DSUSA Orange County - The Achievers
DuMyon Martial Arts
Eagle Mount Billings
Eagle Mount Bozeman
Eagle Mount Great Falls
EDD Adaptive Sports
Far West Wheelchair Athletic Association
Florida Disabled Outdoors Association
Footloose Sailing Association
Foresight Ski Guides Inc.
Full Circle Farm Therapeutic Horsemanship
GallopNYC - Giving Alternative Learners UpLifting Opportunities, Inc.
Gaylord Hospital, Inc., DBA Gaylord Sports Association
Golf 4 The Disabled
Granite State Adaptive
Greater Buffalo Adaptive Sports
Great Lakes Adaptive Sports Association (GLASA)
Greek Peak Adaptive Snowsports
Green Mountain Adaptive Sports
Higher Ground Sun Valley, Inc.
Hillsborough County Adaptive Sports
Ignite Adaptive Sports
Kinetic Kids, Inc.
Lakeshore Foundation
Lakes Region Disabled Sports at Gunstock, Inc.
Leaps of Faith Water Ski Club dba LOF Adaptive Skiers
Live Water Foundation
Lone Star Paralysis Foundation
Louisiana GUMBO Inc.
Lounsbury Adaptive Ski Program
Maine Adaptive Sports & Recreation
Maryland Therapeutic Riding, Inc.
Medstar NRH Adaptive Sports & Fitness Program
Michigan Adaptive Sports
Michigan Sports Unlimited, INC
Midwest Adaptive Sports
Morgan's Wonderland Sports - STRAPS
Move Along, Inc.
National Sports Center for the Disabled
New England Disabled Sports
New England Healing Sports Association
Northeast Disabled Athletic Association
Northeast Passage
Northern Arizona Adaptive Sports Association
North Side Archery Club
Oak Hill Adaptive Sports And Fitness
Ogden Valley Adaptive Sports
Oklahoma Adaptive Sports Association
One Chair At A Time
On The Edge Children's Foundation
Operation Comfort
Operation Surf
ORCA Program - Southeast Alaska Independent Living, Inc.
Oregon Adaptive Sports
Outdoors for All Foundation
ParaSport Spokane
Pennsylvania Center for Adapted Sports
Prairie Grit Adaptive Sports
Rehabilitation Hospital of Indiana Sports Program
Rehabilitation Institute Of Michigan Foundation
RISE Adventures, Inc. DBA RISE Adaptive Sports
Rochester Accessible Adventures
Rochester Community Inclusive Rowing
Roger C. Peace Rehabilitation Hospital
S.M.C.L. Foundation & Associates Inc. Adaptive & Disability Sports Organization
Salt Lake County
Seattle Adaptive Sports
Servicemembers Undertaking Disabled Sports (SUDS)
Shirley Ryan AbilityLab
Ski Apache Adaptive Sports
Southeastern Wisconsin Adaptive Ski Program
Southern Arizona Adaptive Sports
Southwest Wheelchair Athletic Association
Spaulding Adaptive Sports Centers (Spaulding Rehabilitation Network)
Special Outdoor Leisure Opportunities (SOLO)
Sportable
Sports, Arts & Recreation of Chattanooga (SPARC)
Sports, Therapeutic and Adaptive Recreation (STAR) Association
Steamboat Adaptive Recreational Sports (STARS)
STRIDE Adaptive Sports
Team River Runner, Inc.
Telluride Adaptive Sports Program
Teton Adaptive Sports
The Center for Individuals with Physical Challenges
Therapeutic Adventures, Inc.
Three Rivers Adaptive Sports
Three Trackers of Ohio
Tri-State Wheelchair Athletic Association DBA Tri-State Wheelchair & Ambulatory Athletics (TSWAA)
Triumph Foundation
Turning Point - Paraplegics On Independent Nature Trips
Turnstone Center for Disabled Children and Adults, Inc.
Two Top Mountain Adaptive Sports Foundation Inc.
United States Driving for the Disabled
University of Central Oklahoma Center of Adaptive Sports
US Adaptive Recreation Center
US Electric Wheelchair Hockey Association
Vermont Adaptive Ski & Sports Association
Visually Impaired & Blind Skiers
Warrior Sailing
Wasatch Adaptive Sports
Waterville Valley Adaptive Sports
Wichita Adaptive Sports INC
Wintergreen Adaptive Sports
Wisconsin Adaptive Sports Association (WASA)
Youth Challenge
Other (please list below)