IOWA HIGH SCHOOL ATHLETIC ASSOCIATION

* (515) 432-2011 * P.O. Box 10, Boone IA 50036-0010 * Fax (515) 432-2961 *

CONTRACT WITH REGISTERED OFFICIAL(S) OF THE I.H.S.A.A.

This contract is between the High School, , IA (zip) and of , (ZIP)	in his/her capacity as an independent contractor and as a registered official of the Iowa High School Athletic Association. Said Official agrees to be present and officiate a game or meet at , IA on , 20 , at o’clock, M.

In consideration of said services, the above school will pay to the said Official an officiating fee of $ and mileage at the rate of 40 cents per mile one way, most direct route. The Official agrees that this sum shall cover all of his/her claims arising from the contract; and the Official and School jointly agree that said Official shall, at all times, during the term of this contract, be and operate as an independent contractor. It is further agreed that if either party hereto fails to fulfill the obligation of this contract, that party shall pay to the other party the sum of $ as damages for violation of the contract and said failure shall be reported to the IHSAA.

Signed in duplicate this day of , 20 .

Home Phone

For the School	Bus. Phone

SUPERINTENDENT, PRINCIPAL, OR ATHLETIC DIRECTOR

Home Phone

For the Official	Bus. Phone

OFFICIAL’S NAME (PRINT/TYPE)

STREET ADDRESS/BOX NO.	TOWN	ZIP

SOCIAL SECURITY NUMBER	OFFICIALS SIGNATURE

*COMPLETE IF CREW MEMBERS ARE NOT CONTRACTED SEPARATELY

Home Phone

*For the Official	Bus. Phone

OFFICIAL’S NAME (PRINT/TYPE)

STREET ADDRESS/BOX NO.	TOWN	ZIP

SOCIAL SECURITY NUMBER	OFFICIALS SIGNATURE

Home Phone

*For the Official	Bus. Phone

OFFICIAL’S NAME (PRINT/TYPE)

STREET ADDRESS/BOX NO.	TOWN	ZIP

SOCIAL SECURITY NUMBER	OFFICIALS SIGNATURE

Home Phone

*For the Official	Bus. Phone

OFFICIAL’S NAME (PRINT/TYPE)

STREET ADDRESS/BOX NO.	TOWN	ZIP

SOCIAL SECURITY NUMBER	OFFICIALS SIGNATURE

Home Phone

*For the Official	Bus. Phone

OFFICIAL’S NAME (PRINT/TYPE)

STREET ADDRESS/BOX NO.	TOWN	ZIP

SOCIAL SECURITY NUMBER	OFFICIALS SIGNATURE

IOWA HIGH SCHOOL ATHLETIC ASSOCIATION

Joseph S. Loria

2004-02-13

The University of Iowa