MONTANA HIGH SCHOOL ASSOCIATION - ArbiterSports



2018-2019 REGISTRATION

Montana Officials’ Association – 1 South Dakota Avenue – Helena, MT 59601

406-442-6010 406.442.8250

|NAME: |      |

|ADDRESS: |      |

| |                  |

| |City State Zip Code |

|PHONE: |                  |

| |Home Business Cell |

|EMAIL: |      |

The following MUST be provided for the purpose of conducting criminal history checks. The information must be truthful, complete and accurate or the application may be returned or the registration rescinded.

| | |

|Date of Birth      /     /      |MOA CONVICTION STATUS POLICY |

| |Have you been convicted of: (a) a felony involving the use, possession or sale|

|Gender Male Female |of a controlled substance within the last ten years; (b) a crime involving the|

| |use or threatened use of violence against a person within the last ten years; |

|Race |or (c) a crime involving a minor child at any time? |

|Asian Native American | |

|Black White |No Yes |

|Hispanic Other | |

| |If yes, please submit a written explanation regarding the matter as it relates|

| |to your role as an official. |

| | |

|Please indicate the sport(s) for which you are registering. |FEES: |

|Basketball is ONE sport whether you work girls’, boys’ or |1ST Sport @ $65.00 $ 65.00 |

|both. |Each additional Sport # @ $30.00 $ |

| |MCA (Montana Coaches Association) Associate Membership |

|BASKETBALL FOOTBALL |(optional) for non-coaching officials @ $35.00 $ |

|SOFTBALL VOLLEYBALL |If you are a coach, you must contact the MCA for membership. |

|SOCCER WRESTLING |Late Fee (May 16th – June 1st) @ $10.00 $ 10.00 |

|Assignment of regular season contests occurs at the local pool|Late Fee (After June 1st) @ $25.00 $ 25.00 |

|level. Local pools provide game assignments, training, and |TOTAL AMOUNT PAID $       |

|give you peer to peer mentoring and tutoring needed for you to| |

|develop as an official. Please list below the name(s) of the |Please make checks payable to MHSA and mail along with this form to: MHSA, 1 |

|pool(s) [one pool per sport] of which you will be a member: |South Dakota Avenue, Helena, MT 59601 |

|     _______________________________________ | |

|_______________________________________________ | |

By signing and submitting this application, I consent to a public criminal records background search and acknowledge that if I am found to have been convicted or am in a period of deferred imposition for any crimes listed in the MOA Conviction Status Policy, subject to the right of appeal, I will be considered ineligible for an official position with the MOA. Further, by my signature below, I acknowledge that I have read and agree to the Independent Contractor Agreement detailed on the back (page 2) of this application.

SIGNATURE OF APPLICANT

MAIL COMPLETED APPLICATION AND CORRECT PAYMENT TO:

MHSA/MOA, 1 South Dakota Avenue, Helena, Mt 59601

1. To assure prompt registration, forward completed registration application and check or money order to: MHSA/MOA, 1 South Dakota Avenue, Helena, MT 59601. The late fee will not be waived for any reason. If an official fails to receive a renewal application in April, it is his/her responsibility to contact the MHSA and request a duplicate form. The MOA is not responsible for mail or delivery delays or failures.

2. I understand that I am applying to be an MOA registered official, and that being registered entitles me to officiate contests between MHSA member schools for remuneration as an independent contractor and not as an employee of the MHSA/MOA. I understand and acknowledge that I have no entitlements with or from the MHSA/MOA which may be available to an employee of the MHSA/MOA. I agree to abide by the rules and policies set forth by the MHSA/MOA and my local pool as written and interpreted to maintain said registration; and I attest that the information provided in this application form is true and accurate. Failure to provide true and accurate information could result in criminal prosecution and/or immediate cancellation of registration with the MOA. Membership in a pool and/or the MOA does not guarantee game assignments. In accepting game assignments from the pool, I am acting as an independent contractor and not in any way considered an employee of the MHSA/MOA

I further understand that as an independent contractor I am solely responsible for my acts during the performance of my officiating duties and that as an independent contractor:

1. I am responsible for any and all taxes on my officiating income.

2. I am not entitled to any employee benefits including, but not limited to, worker's compensation, unemployment benefits and medical insurance.

3. Payment for my services originates from the organizations responsible for the contests (MHSA/MOA, schools etc.) NOT the local pool or any other assigning organization.

Your signature on this membership application acknowledges that you have read and agree to the above Independent Contractor Agreement.

3. Membership in the MOA is attained by paying the Association dues and scoring a minimum of 60% on the appropriate rules examination. Dues must be paid prior to the qualifying exam and include payment for rules manuals, study materials and premiums for liability and supplemental medical insurance. If the official fails or does not take the examination, no refunds are provided. Registering officials are subject to a public criminal records background search. If he/she is found to have been convicted or is in a period of deferred imposition for any crime listed in the MOA Conviction Status Policy (see #9 below), subject to the right of appeal, he/she will be considered ineligible for membership. Date of birth, gender and race information is required to obtain accurate retrieval of records and will only be used for criminal history background checks and cumulative data analysis (e.g., total number of male and female officials). Once the initial criminal history check has been conducted, officials will be subject to on-going, random checks.

4. RATINGS: The MOA has three (3) classifications. Apprentice, certified and master. An official must serve two consecutive years at apprentice and receive a favorable recommendation from his/her evaluation committee and Director before testing up to certified. An official must serve two consecutive years at certified, receive a favorable recommendation from his/her evaluation committee and Director and officiate a minimum number of varsity contests before testing up to master. Other requirements for maintaining or upgrading your rating include a requisite number of study clubs for each sport(s), yearly concussion training and viewing the annual clinic(s) offered for each sport(s).

5. LATE FEE: Dues are outstanding after May 15th of each year. If dues are not postmarked on or before May 15th, a $10.00 late payment penalty is assessed for any dues paid between May 16th and June 1st. If dues are postmarked after June 1st, a $25.00 late payment penalty is assessed and the official must pass the annual qualifying examination for that rating. This applies to all classifications. Failure to pass the exam with the required score will result in a rating reduction of one classification for master and certified officials and loss of membership for apprentice officials. Failure to take the examination will result in loss of membership and no refund of dues will be provided. In addition upgrading is denied for one year for failure to pay dues by June 1st.

6. RECIPROCAL MEMBERSHIP IN BORDERING STATES: Members of the MOA can join as members of the officials association in the bordering states of North Dakota, South Dakota, Wyoming and/or Idaho by paying dues of $10.00 per sport to that/those particular state’s organization. Dues must be paid before the official works a contest. This five-state agreement entitles members of each respective organization to officiate in any state(s) in which they maintain membership.

7. OUT OF STATE TRANSFERS: A member from another state may transfer to the MOA providing the MOA office receives a letter from their current officials organization confirming that their membership was in good standing and must pay prescribed dues to the MOA. A transferring official will have their rating based on their current out-of-state rating, however, an official will not receive a rating above the certified classification for the first year.

8. ASSOCIATE MEMBERSHIP: High school students may become associate members of the MOA by passing the MOA qualifying exam(s). They may work sub-varsity contests and will receive credit for their years of experience when they apply for regular membership provided they meet the same criteria as a regular member. Associate dues will be one-half of regular member dues.

9. CONVICTION STATUS POLICY: An individual who is convicted of: (a) a felony involving the use, possession or sale of a controlled substance within the last ten years or (b) a crime involving the use or threatened use of violence against a person within the last ten years, is prohibited from membership in the MOA; an official who is convicted of (c) a crime involving a minor child at any time is subject to lifetime suspension from membership in the MOA. The Executive Director or his/her designee will review any information submitted by an applicant or others, regarding criminal history and make an individual and confidential determination with regard to the official’s status. REINSTATEMENT: Following ten (10) years from the date of conviction or deferred imposition, an individual permanently prohibited from membership pursuant to subpart (c) above may apply to the MHSA Executive Board for reinstatement upon a showing by clear and convincing evidence that the individual is not a threat to minor children and is otherwise qualified for MOA membership.

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