Agreement Form - Prince William County Government

Agreement Form
In order for a league to be recognized by PWC Parks and Recreation, it must meet the
below listed requirements. (Where “leagues” are mentioned, the requirement refers
to groups scheduled by the Sports Services Manager only.)
a. Comprised of a minimum of five (5) teams with the appropriate number of
b. Eighty percent (80%) of each league’s membership must be residents of
Prince William County. Signature on this form certifies compliance with
this percentage. Rosters of names and addresses of participants will be
used to verify this percentage. If the group has less than 80% residents,
space will be allocated to those participants from the County. Space for
individuals not from Prince William County may have to be provided by
their resident jurisdiction unless some previous written agreement has
been approved;
c. The group must annually sign a hold harmless agreement with PWC Parks
and Recreation;
d. Provide proof of not for profit status (501c.3) or self -certify as a not for
profit organization.
e. Purchase and maintain General Liability insurance. The Certificate of
Insurance must name PWC Public Schools and PWC Parks and Recreation
as “Additionally Insured”.
f. League representatives are expected to attend seasonal scheduling
meetings where applicable;
g. The league will be required to submit rosters by team before the permit
can be released (prior to the permit being sent). Within four (4) weeks of
the first date of use, submit a complete, current roster (by team) of all
participants registered for the new season, the rosters to include the full
name and home (street) address with the city, state and zip code. Failure
to comply will revoke authorized use and return space to the available
scheduling inventory;
h. It is a requirement that each league must stipulate policy on game time
exposure (participant play time). If the league chooses not to have such a
policy, it must so state;
i. A criminal history check is required for league representatives and
Agreement Form
j. A copy of the following documents must be submitted to PWC Parks and
Recreation at the pre-season meeting:
1. A copy of the organization’s Bylaws and roster of elected officials:
2. The organization’s written code of conduct for athletes, spectators and
3. The organization’s policy delineating established disciplinary
4. The organization’s emergency communications plan;
5. The organization’s previous year’s game and practice schedules;
6. Notifications of any registration fees, equipment fees or other fees
charged to participants or participating teams;
k. PWC Parks and Recreation reserves the right not to permit groups that
have demonstrated unfair or inequitable policies.
l. A league must comply with the Athletic Field and Facility Use Manual and
the attachments;
m. No organization may sponsor any other organization for the purpose of
altering the classification or fee schedule of such other organization;
n. The league will not deny registration to any Prince William County citizen
unless it can be determined that a more appropriate organization exists
which operates a like activity.
As representative of this league, I agree to take the responsibility of assuring PWC
Parks and Recreation that this league and all league participants adhere to the policies
as described in the Athletic Field and Facility Use Manual. I understand that failure to
comply with the policies will result in forfeit of our league field or gym time, until the
requirements are satisfied.
League Name:
Authorized Signature:
League Position/Title:
Are you a Not For Profit Organization? ___ Yes
___ No