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KENTUCKY HIGH SCHOOL ATHLETIC DIRECTORS ASSOCIATION
36th ANNUAL CONFERENCE
April 24-27, 2012Ramada Plaza Hotel
9700 Bluegrass ParkwayLouisville, KY
ACADEMICS & ATHLETICS = EXCELLENCE IN STUDENT PERFORMANCE
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Welcome Athletic Directors
The 36th Annual State Athletic Directors’ Conference will be conducted at the RamadaPlaza Hotel at 9700 Bluegrass Parkway (off of I-64 & Hurstbourne Parkway) inLouisville. The Conference will be April 24-27, 2012.
The State Conference is a Professional meeting and expenses for attending can bereimbursed under the authority of Section 156.190 of the Kentucky Revised Statues. TheState Conference is a first-class conference featuring professional speakers, as well asauthoritative athletic administrators who willingly share their experience and expertise ona variety of subjects.
The KHSADA will offer the NIAAA Leadership Training Program courses on TuesdayApril 24th, Wednesday April 25th and again on Friday April 27th. Those athletic directorstaking these Leadership Courses will receive 4 hours of EILA credit for each course thatis approved and completed. All courses are outstanding and you will want to work at leastone of these courses into your conference agenda.
New this year will be several sessions regarding middle school athleticprograms. If your school district offers middle school athletics yourmiddle school athletic director can take a Leadership Training Coursejust for middle schools and attend a session on Thursday from 1-2 PMtake will deal with middle school program development. Those middleschool athletic directors attending the conference must register and payfor attending the conference. They will receive all conference benefits.
The Conference Committee would like all attendees to enjoy the entire conferenceexperience. First-time attendees are encouraged to attend the first-time registrationsession on Wednesday April 25th from 7:15-7:45 PM.
As a courtesy to our speakers and presenters we request all attendees to arrive ontime for each workshop or LTP course offering.
The conference Awards banquet program conducted at Papa John’s Cardinal Stadium,allows attendees to recognize their peers and outstanding individuals from acrossKentucky who have given countless hours of loyalty and dedication to athletics in theirrespective communities.
Plan now to attend YOUR State Athletic Directors Conference.
YOU WON’T BE DISAPPOINTED!
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General Conference Information
Included in this conference booklet are all the necessary information to register for theconference, golf classic, NIAAA Leadership Training Courses, hotel room reservation,State and National Athletic Directors Associations membership forms and a KHSADABoard of Directors nomination form.
The Ramada Plaza Hotel has offered a special room package of $93 for one person and$113 for two people. The difference in rates is due to the Welcome Gifts offered by theRamada Plaza Hotel. Each person registered at the Ramada Plaza Hotel will receive theWelcome Gifts, which include a mini fruit basket, Derby glass and more. You mustregister accordingly on the enclosed registration form. List both names if two people aresharing the room. The Ramada Plaza Hotel will sponsor 2 Conference events; the golfclassic and the Wednesday night Manager Party and will also give away a free weekendstay for two.
The golf classic event will be conducted at Seneca Golf Course located on Pee WeeReese Lane off of Taylorsville Road and the Watterson Expressway. The fee of $65includes green fee, cart, beverages, lunch and a special gift to each golfer. In the event ofrain the cart and green fee will be refunded.
The University of Louisville will once again host the Annual KHSADA Awards Programat Papa John’s Cardinal Stadium. The awards program is the highlight of the conferencewhere the 5 finalist for Athletic Director of the year are presented along with the namingof the Athletic Director of the Year. The KHSADA will also present severalDistinguished Service Awards to deserving individuals from across Kentucky as well asthe NIAAA State Award of Merit and the Army National Guard will award the 2nd
Annual All Resilient Team Awards.
The retired athletic directors will have several opportunities for conference involvement.The 50/50 raffle is conducted by the retired athletic directors and there will be a retiredathletic director’s breakfast on Thursday April 26th 7:30-8:00 AM. Also, the retiredathletic directors will have a golf outing on Thursday April 26th from 9:30 AM to 1:30PM. All registered retired athletic directors are invited as guests of the KHSADA toattend the Awards Banquet on Thursday April 26th at 6:30 PM at Papa John’s CardinalStadium.
The KHSADA and MPC Promotions will have the KHSADA Logo Shoppe open duringthe conference in the Exhibit Hall on Wednesday and Thursday. You can purchase yourKHSADA, NIAAA casual wear or order items with your school logo. Stop by the MPCPromotions booth to see the new clothing selection. MPC Promotions is a CorporateSponsor of the KHSADA.
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CONFERENCE REGISTRATION INFORMATION
Please Read CarefullyPlease note the following instructions/procedures to be followed when completingthe necessary registration forms:
1. Please type or print legibly on all forms2. Make copies of all completed forms for your files.
Conference Registration
1. Attendee registration fee is $125 if paid and received prior to April 1, 2012. AfterApril 1, 2012 the fee is $150. Included in your registration will be 3 meals,conference registration gifts, 2 hospitality receptions, outstanding speakerprogram, over 60 exhibitors and much more. A SERVICE FEE OF $75 WILLBE CHARGED FOR CANCELLATION AFTER APRIL 1, 2012.
2. KHSADA membership dues may be paid on the registration form. You will alsoneed to complete the KHSADA enrollment form and return with conferenceregistration. This form insures you of your life insurance coverage.
3. NIAAA membership dues may be paid on the registration form. You will alsoneed to complete the KHSADA enrollment form and return with conferenceregistration. This form insures you of your life insurance coverage.
4. Registration for the conference golf classic may be paid on the registration form.You will also need to complete the Golf Classic enrollment form and return withconference registration.
5. NIAAA Leadership Training Course enrollment may be paid on the registrationform. You will also need to complete the LTC enrollment form on the conferenceregistration and indicate which LTP courses you wish to enroll.
6. Retired Athletic Director registration fees and membership dues may be paid onthe retired athletic director registration form.
7. Hotel room reservations must be made by completing the hotel room reservationform and return to the Ramada Plaza Hotel as indicated. Or, you may callReservations at 502-491-4830.
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CONFERENCE AGENDA
TUESDAY – APRIL 24, 2012
3:30-7:30 PM NIAAA Leadership Training Course, 502- Principles, Strategiesand Methods, Appalachian
NIAAA Leadership Training Course, 714 – Dealing WithChallenging Personalities, Iroquois
NIAAA Leadership Training Course, 619 – The Power of CurbAppeal, Heartland
6:00-7:00 PM KHSADA Legislative Committee Meeting – Goldenrod
7:30-9:30 PM KHSADA Board of Directors Meeting – Goldenrod
7:00 PM - ?? KHSADA Hospitality Room Open,(Sponsored by the Metro Area Athletic Directors Association andthe 11th Region Athletic Directors Association)
WEDNESDAY – APRIL 25, 2012
7:00 AM Depart for golf tournament (transportation provided) meet atConference Center
8:00 AM-2:00 PM 25th Annual KHSADA/Ramada Plaza Hotel Golf Classic at SenecaGolf Course, Continental breakfast served at Golf Course
9:00 AM-1:00 PM NIAAA Leadership Training Course, 511 – Concepts andStrategies for Interscholastic Budgeting and Finance Using ExcelSpreadsheets, Appalachian
NIAAA Leadership Training Course, 625 – Management of Gameand Event Announcing, Iroquois
NIAAA Leadership Training Course, 790 – Leadership TrainingInstructional Methods and Techniques, Heartland
NIAAA Leadership Training Course, 700 – Leadership TrainingDevelopmental Theory of Middle School Athletic Programs,Burley
2:00-4:00 PM Exhibitor Setup, Grand Belle Hall
4:00-9:00 PM Exhibit Hall Open, Grand Belle Hall
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WEDNESDAY – APRIL 25, 2012 (continued)
3:00-8:00 PM Conference Attendee and Exhibitor Registration, Jefferson
5:30-6:15 PM Managers Welcome Party (sponsored by Ramada Plaza Hotel) allathletic directors and exhibitors welcome, Grand Belle Hall
4:00-9:00 PM Exhibit Hall Open, Grand Belle Hall
7:15-7:45 PM 1st Time Conference Attendees meeting, Derby
6:30-7:15 PM Opening General Session, Grand Belle HallSpeaker: U of L Athletic Department Representative
7:15-7:45 PM Introduction of State Athletic Director of the Year candidatesPresentation of Regional Athletic Director of the Year Awards
7:45-8:00 PM Door Prizes
8:00 PM Hospitality Room Open & Game Night (Sponsored by ArmyNational Guard)
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THURSDAY – APRIL 26, 2012
7:30-8:15 AM Retired Athletic Directors Breakfast/Meeting, Heartland
8:00 AM-5:00 PM Exhibit Hall Open – Grand Belle Hall
8:00-11:30 AM Conference Registration, Jefferson
8:30-10:00 AM 2nd General Session – Breakfast, Julia Belle BallroomSpeaker: Kenny Davis, Olympic Basketball Player
KHSADA Athletic Director of the Year voting
9:00 AM-1:30 PM Retired Athletic Directors Golf Outing (Heritage Hills GolfCourse)
10:15 AM Door Prizes, Regions 1-8 (Exhibit Hall), Grand Belle Hall
11:00 AM- Noon Workshop #1 – Profession Development for Athletic Directors andCoaches, FarmingtonSpeaker:
Workshop #2 – KTRS, Planning for the Future, GoldenrodSpeaker: KTRS Representative
12:00-1:00 PM Picnic Lunch, Grand Belle Hall
1:00-2:00 PM Workshop #3 – Current Issues in Sports (3 rotating topics),Burley, Cumberland, Derby
1:00-2:00 PM Workshop #4 – Middle School Athletic Program Development,Heartland
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THURSDAY – APRIL 28, 2012
2:15-3:45 PM Workshop #5 – Collegiate Opportunities – DII, DIII & NAIAPrograms, FarmingtonSpeakers: Representatives from Kentucky Universities
3:45-5:00 PM Exhibit Hall Open, Door Prizes Regions 9-16, Exhibitor DoorPrizes
4:00-4:30 PM CAA Exam Review Session, Burley
5:30-6:00 PM Transport to U of L Papa John’s Cardinal Stadium (buses depart)
6:00-8:00 PM KHSADA Awards Banquet, Sponsored by the University ofLouisville (Athletic Director of the Year Award, NIAAA StateAward of Merit, KHSADA Distinguished Service Awards and AllResilient Team presentations)
8:00-8:15 PM Transportation from Papa John’s Cardinal Stadium to RamadaPlaza
8:30 PM-?? KHSADA Hospitality Room –
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FRIDAY – APRIL 27, 2012
8:15-8:45 AM New KHSADA Board Member Orientation, Appalachian
9:00 10:15 AM Workshop #6, Open Forum, KHSAA Staff & Board of ControlMembers, Farmington
10:30 AM-12 Noon Closing General Session and Derby Brunch, Julia Belle BallroomSpeaker: Julian Tackett, KHSAA CommissionerModerator: Mitchell Irvin, CAA, KHSADA President
Ramada Plaza Hotel Weekend Giveaway50/50 Raffle Drawing2013 KHSADA Conference Registration Giveaway
12:15-1:15 PM KHSADA Board of Directors Meeting, Julia Belle Ballroom
12:30-2:00 PM NIAAA CAA Exam, Burley
12:30-4:30 PM NIAAA Leadership Training Course, 724 – Stress ManagementMethods, Techniques and Systems, Appalachian
NIAAA Leadership Training Course, 721 – Positive SportingBehavior – For the Love of the Game, Iroquois
NIAAA Leadership Training Course, 616 – Management of IndoorPhysical Plant Assets, Heartland
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CONFERENCE WORKSHOPS
Thursday – April 26, 2012 11:00-12:00 Noon
Workshop #1 Professional Development for Athletic Directors & Coaches -Farmington
This workshop will offer a panel discussion on how to secure the best professionaldevelopment for your athletic department.
Workshop #2 KTRS – Retirement Planning - Goldenrod
This workshop will focus on the timelines for retirement and any new developments inthe KTRS program.
Workshop #3 Current Issues in Sports – Burley, Cumberland, Derby
This workshop will be in 3 20 minute sessions. There will be a panel of athletic directorsin each session with time for questions.
Thursday – April 26, 2012 2:15-3:34 PM
Workshop #4 Development of Middle School Athletic Programs – Burley
This panel discussion will center around developing a success middle school program andhow to improve a current program. Discussion will also revolve around the possibleinclusion of middle school programs into the operation of the KHSAA>
Workshop #5 Collegiate Opportunities, DII, DIII, NAIA Programs -Farmington
This workshop will show the differences between the levels of scholarship opportunitiesfor high school athletes. The panel will have representatives from each level and they willinteract with the attendees on how to best utilize the options available to all students.
Friday – April 27, 2012 9:00-10:15 AM
Workshop #6 Open Forum Speakers: KHSAA Staff & Board of Control - Farmington
Members of the KHSAA Staff and Board of Control will be available to answer questionsregarding current KHSAA issues.
This will be the first opportunity for Commissioner Julian Tackett, CAA, to speak beforethe Association. He will have an opportunity to give his views of the direction of theKHSAA and its working relationship with the many different role groups which make upathletics in Kentucky. He will also have an opportunity to introduce new staff members.
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NIAAA LEADERSHIP TRAINING COURSES
The Leadership Training Institute is a broad based curriculum that enhances theleadership potential and ability of KHSADA members to improve job performance. Eachcourse in the program addresses a specific topic in athletic administration.
Objectives of Leadership Training
1. To provide knowledge to improve professionalism in the field of athleticadministration.
2. To develop a leadership pool for involvement in the NIAAA and the KHSADA.3. To help candidates prepare for the NIAAA Certified Athletic Administrator
(CAA) examination.
Benefits of the Leadership Training Institute
1. Improve members’ working knowledge of the NIAAA, NFHS, KHSAA andKHSADA.
2. Assist members in preparation for the Certified Athletic Administratorsexamination.
3. Prepare members for service on NIAAA and KHSADA committees.4. Improve members’ working knowledge and competencies in athletic
administration.5. Provide resource information in all areas of the curriculum6. Improve professionalism in the field of athletic administration7. Provide the opportunity to earn graduate credit
Attendance Requirements & Refund Procedures
Attendees pre-registered for LTI courses will be admitted to the course and provided amanual. A Certificate will be presented upon completion of the course. Attendees mustnotify LTI State Coordinator Faye Thornton at Sharp Middle School.([email protected]) before April 1st if they are withdrawing fromcourse to receive full refund. All no shows will forfeit registration fees.
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LTI COURSES
TUESDAY – APRIL 24, 2012
3:30-7:30 PM NIAAA LTI Course, 502 - Principles, Strategies and Methods -Appalachian
NIAAA LTI Course, 714 - Dealing With Challenging Personalities- Iroquois
NIAAA LTI Course, 619 – The Power of Curb Appeal -Heartland
WEDNESDAY – APRIL 25, 2012
9:00 AM-1:00 PM NIAAA LTI Course, 511 – Concepts and Strategies forInterscholastic Budgeting and Finance Using Excel Spreadsheets -Appalachian
NIAAA LTI Course, 625 – Management of Game and EventAnnouncing - Iroquois
NIAAA LTI Course, 790 – Leadership Training InstructionMethods and Techniques – Heartland
NIAAA LTI Course 700 – Developmental Theory of MiddleSchool Athletic Programs - Burley
FRIDAY – APRIL 27, 2012
12:30-4:30 PM NIAAA LTI Course, 724 – Stress Management Methods,Techniques and Systems - Appalachian
NIAAA LTI Course, 721 – Positive Sporting Behavior – For theLove of the Game - Iroquois
NIAAA LTI Course, 616 – Management of Indoor Physical PlantAssets - Heartland
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LTC 714 Athletic Administration: Dealing With ChallengingPersonalities
EILA Credit 4 hours
This course will examine the causes of challenging or difficultpersonalities in society, with specific reference to high school athleticprograms. Basic management strategies will include the use of emotionalintelligence and transactional analysis considerations and methods.Specific protocols will be defined for dealing with individuals who “mustbe right, must win, must be logical and must be accepted. Inaddition, techniques will be covered for preventing or responding toanger, sarcasm, denigration, complainers and backbiters and rigid-obstinate personalities. A model will also be discussed for creativeinteraction with parents who demand involvement in athletic departmentdecision-making or who seek to influence the decisions of senioradministrators.
Enrollees who will derive greatest benefit: Administrators seeking tounderstand the role of human personality in defining a challengingpersonality or behavior and seeking strategies for dealing with extremelyaggressive, rigid, sarcastic passive or condescending personalities.
LTC 619 Athletic Administration: The Power of Curb Appeal
NO EILA Credit
The power of curb appeal is highlighted in this course. Visitors to aschool often form an opinion of the school and community based on firstimpressions of the appearance of the facilities. This course discusses thepower of curb appeal and how communication can enhance curb appeal.Strategies and methods are provided for maintaining structures andfacilities as well as a comprehensive and thorough study of “Best TurfField Maintenance Practices” as well as “Best Operational ManagementPractices.”Enrollees who will derive greatest benefit: Administrators seekingtechniques and methods to enhance public confidence in theadministrator’s ability to maintain athletic facilities and to project apositive image to the community..
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LTC 502 Athletic Administration: Principles, Strategies and Methods
EILA Credit 4 hours
This course takes a basic approach to the fundamentals and methods ofathletic administration and alerts and educates athletic administratorsregarding potential problems and possible solutions in areas such asbudgets, transportation, and scheduling and parent/student/coach conflicts.The course also touches upon sample athletic/activity programphilosophies, department organizational charts, activityprocedures/checklist, public relations, coaching applications/assessmentsand emergency plans.
Enrollees who will derive greatest benefit: Inexperienced athleticadministrators seeking to define and improve their operational procedures.Required for: RAA, CAA and CMAA Certification
LTC 625 Athletic Administration: Management of Game and Event Announcing
NO EILA Credit
This course is designed to assist the athletic administrator in understandinghis/her role in managing the public address program for athletic contests.Topics include the role of the athletic administrator and announcer,announcing guidelines for addressing emergency situations, securitysituations, and unsportsmanlike situations, pre-game, during contest andpost game announcements; halftimes; preparing student announcers andunderstanding sound systems. Attendees will receive announcingguidelines endorsed by the NIAAA, NAIA and the NJCAA. A CDaddresses key issues regarding public address announcing anddemonstrates proper and improper announcements.
Enrollees who will derive greatest benefit: Administrators interested inusing contest announcement techniques to project a positive image, toassist in maintaining high standards of sportsmanship and spectator safety
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LTC 511 Athletic Administration: Concepts and Strategies for InterscholasticBudgeting and Finance Using Excel Spreadsheets
EILA Credit 4 hours
This course of study provides an overview of accepted managementpractices and strategies. Included are budget models, timeline,documentation practices and suggested strategies for long range planning.A major component of this course will be desktop budget managementusing Excel Spreadsheets. It is highly recommended that attendees bring alaptop computer with at least Windows 2003, including Excel.
Enrollees who will derive the greatest benefit: Administrators desiringto incorporate Microsoft Excel and computer programs into budgetmanagement practices.
LTC 790 Athletic Administration: Leadership Training Instructional Methodsand Techniques
NO EILA Credit
This course is designed to provide instructors with an awareness of theexpectations that are placed upon them in presenting LTP courses. Thecourse examines teaching and learning styles and provides strategies forinstructors to use in teaching LTP courses. It provides for interactionbetween current national faculty instructors and potential LTP instructorsin the exchange of ideas used in the successful implementation of courses.To instruct any LTP course, one must complete LTC 501, LTC 790 andthe course that one will be instructing. Only National ConferencePresentation Faculty is permitted to teach 790.
Enrollees who will derive greatest benefit: Administrators seeking tobecome instructors in the Leadership Training Program.
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LTC 700 Athletic Administration: Development Theory of Middle School Athletic Programs
NO EILA Credit
This course provides insights and strategies for the leadership ofdevelopmentally sound educationally compatible middle level schoolathletic programs. Middle school philosophy is discussed along with therelationship it has to the psychological and physical development of themiddle school child. This course also focuses on concerns and/orchallenges raised about the value of middle school sports programs intoday’s educational setting.
Enrollees who will derive greatest benefit: Middle and high schoolathletic administrators and coaches with limited perspective of the role ofmiddle school sports and the development needs of the middle schoolstudent.
LTC 724 Athletic Administration: Stress Management Methods, Techniquesand Systems
NO EILA Credit
The demands of high intensity daily work, evening and weekendsupervision requirements, demanding public expectations, challenginginteractions and limited resources place the athletics director in a stressfulposition. Needed are ways of intervening stress, managing its onset andusing proven methods for reducing its impact.
Stress will ALWAYS be present. Our perceptions of it determine the waywe react and also help define the methods we choose to intervene.Because of the individual nature of perception and preferred response thiscourse will provide an overview of individual methods (breathing control,muscle relaxation and mindfulness) along with systems drawn both fromconventional Western medical practices and Eastern alternative orcomplementary medicine. In the latter area, an introduction toYoga/Meditation, Tai Chi, Ai Chi, Acupuncture and Healing Touch willbe used to complement the more traditional pain and stress managementpractices.
Enrollees who will derive greatest benefit: Administrators seeking newconcepts, methods and additional strategies for dealing with stress in theirdaily activities.
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LTC 616 Athletic Administration: Management of Indoor Physical Plant Assets
EILA Credit 4 hours
This course will consider spectator facilities, special use gymnasia,natatoriums, laundry rooms and locker rooms and the various systems thatsupport them. Mechanical system checklists for use in regular inspectionsand maintenance programming will be provided. In addition,considerations and issues related to construction and remodeling programswill be discussed.
Enrollees who will derive greatest benefit: Administrators seekingguidance concerning management, maintenance and construction orremodeling of sport facilities and methods to enhance customersatisfaction and safety
LTC 721 Athletic Administration: Positive Sporting Behavior – For the Love of the Game
EILA Credit 4 hours
In this course students will learn to implement appropriate strategies andtechniques, designed to create a positive, productive learning environment,which will support a system that encourages character and self-disciplineand sportsmanship. This class will provide opportunities for selfassessment and reflection in regards to prior performance. In additionstudents will participate in class discussions, and activities which willincrease their knowledge and skills of the effective components ofsuccessful character, citizenship and sportsmanship to share with theirstudents, coaches, parents and communities.
Enrollees who will derive greatest benefit: Administrators seekingstrategies and concepts to implement and/or enhance the understanding ofand involvement in a positive sporting environment for staff, students andcommunity.
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CONFERENCE REGISTRATION FORM
Name
School
Address
City ZIP
Office Phone
Pertinent Information:
Registrant is: Male Female
RAA CAA CMAA
Years Athletic Director Region ___ Retired Member
_____ Graduate Student/Intern This is my first AD Conference
Cancellation Policy: A $75 service fee will be assessed for cancellationafter April 1, 2012. Price TotalConference Registration Fee $125 $
Graduate Student/Intern Registration Fee $90 $_____
Conference Registration Fee after April 1st $150 $_____
KHSADA Dues $50 $
Graduate Student/Intern KHSADA Dues $25 $_____
NIAAA Dues $80 $
Golf Classic Fee $65 $
Subtotal $
CONTINUE REGISTRATION ON BACK OF THIS PAGE
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NIAAA LTI Course Registration
Tuesday – April 24, 2012 3:30-7:30 PM Price Total
LTC 502 Principles, Strategies and Methods $80 $
LTC 714 Dealing with Challenging Personalities $80 $
LTC 619 The Power of Curb Appeal $80 $_____
Wednesday – April 25, 2012 9:00 AM- 1:00 PM
LTC 511 Concepts and Strategies for InterscholasticBudgeting and Finance Using Excel Spreadsheets $80 $
LTC 625 Management of Game and Event Announcing $80 $_____
LTC 790 Leadership Training Instructional Methods andTechniques $80 $_____
LTC 700 Developmental Theory of Middle School Athletic Programs $80 $_____
Friday – April 27, 2012 12:30-4:30 PM
LTC 724 Stress Management Methods, Techniques andSystems $80 $
LTC 721 Positive Sporting Behavior – For the Love of The Game $80 $
LTC 616 Management of Indoor Physical Plant Assets $80 $_____
Subtotal $
TOTAL CONFERENCE REGISTRATION FEE TOTAL $
Make Check Payable to: KHSADA Conference
Send Check to: Hugh McReynolds, CAA Kentucky High School Athletic Directors Association PO Box 1316 Russellville, KY 42276
Please return all competed conference registration forms with payment
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Golf Registration Form
KHSADA/Ramada Plaza Hotel Golf Classic
Date: Wednesday, April 25, 2012
Site: Seneca Golf Course, Pee Wee Reese Lane Off Watterson Expressway on Taylorsville Road North
Format: Best Ball Scramble
Time: 8:00 AM Shotgun Start
Prizes: To Be Announced
Fee: $65 includes cart, green fees, gift, continental breakfast, beveragesand lunch
Please type or print your name and address below:
Name
School
Address
City ZIP
Average score per 18 holes
Return this golf entry form along withconference registration form and payment
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RETIRED Athletic Director Conference RegistrationForm
The purpose of the Retired Athletic Directors group is to:
1. Serve as mentors for athletic directors2. Recruit and further develop the number of retired athletic directors3. Serve and assist as needed during the conference4. Conduct the 50/50 raffle.
Price Total
1. Basic Registration, includes name badge, hospitality,Managers Party and Retired Athletic Directors Breakfast onThursday April 26, 2012 and Awards Banquet $40 $
2. Full Registration, includes all conference meals,activities and conference gift $90 $
3. Retired Athletic Directors Golf Outing $50 $_____
4. Retired KHSADA Dues* $25 $_____
5. Retired NIAAA Dues* $30 $_____
Total Retired Athletic Director Conference Registration Fees $
*You must complete the KHSADA and NIAAA Membership Forms and return withall registration forms with payment.
Name
Address
City ZIP Code Phone
Email Address
Return this Retired Athletic Director Conference Registration to:Hugh McReynolds, CAA
Kentucky High School Athletic Directors Association PO Box 1316 Russellville, KY 42276
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Retired Athletic Director Golf Outing Registration Form
Date: Thursday, April 26, 2012
Site: Heritage Hills Golf Course
Format: Individual Play
Time: 9:30 AM-1:30 PM
Prizes: To Be Announced
Fee: $50 includes cart, green fees, gift, beverages and lunch
Please type or print your name and address below:
Name
Address
City ZIP Code
Email Address
Score for 18 holes
Return this Retired Athletic Director Golf Registration Formalong with Retired Registration Form and Payment
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Kentucky High School Athletic Directors Association Membership Application2012-13 School Year
(Membership Year is September 1- August 1)__Dr. ____Mr. ____Mrs. ____Ms.
First Name MI Last Name (as it appears on your driver’s license)Informal First Name: __________________Designation: ___________________________Title: ______________________ (if any) (Ph.D., CAA, religious, etc. )Home Address:___________________________________________________City: _______________________State:_________ Zip: __________________Office Telephone No.: (_____ ) _____________________Home Telephone No.: (_____)_____________________Email Address: __________________________________________
For insurance purposes, the following information must be provided:
Social Security No.:__________________________ Date of Birth: ____ - ____ - _______Male __FemaleSchool or Organization: _____________________ Basketball Region #: ______
Office Address: _____________________ City: ______________________________State:_________ Zip: __________
Preferred Mailing Address: ___Home ___School/Organization
Price TotalRegular Membership $50 $_____Retired Membership $25 $_____Graduate Student/Intern Membership $25 $_____
Total $_____
Life Insurance Information:Active Member under age 70 $5000 Life Insurance and $5000 AD&DActive Member 70 and over $2500 Life Insurance and $2500 AD& DRetired Member under age 70 $5000 Life Insurance and No AD & DRetired Member 70 and over $2500 Life Insurance and No AD & D
Graduate Student/Intern does not have insurance coverage
YOU MUST COMPLETE THIS FORM TO HAVE THE INSURANCECOVERAGE
Complete this form and return along with conferenceregistration form
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NIAAA Membership Renewal Form 2012-2013
___ Mr. ___ Mrs. ___ Ms. ___ Dr.
___ New Member ___ Renewal Member ID#
First Name MI Last Name(As it appears on your drivers’ license)
School or Organization:
Office Address: City:State ZIP
Office Phone Home Phone
Fax: Email address:
Home Address CityState ZIP
Preferred Mailing Address: ___ Home ___ School SSN:
For life insurance purposes, the following must be provided:
Birthdate _____ - _____ - _____ __ Male ___ Female Smoker __ No __ Yes
Please select one category___ Caucasian ___Latino ___American Indian ___Asian___ Pacific Islander ___African American ___Multi-Cultural___ Alaskan Native Price TotalRegular Membership $80 $_____Retired Membership $30 $_____Regular Life Time Membership $800 $_____
TOTAL $_____
YOU MUST COMPLETE THIS FORM TO HAVE INSURANCE COVERAGEComplete this form and return along with conference
registration form
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Athletic Director Reservation Form – Hotel RoomRamada Plaza Hotel
NameSchoolAddressCity State ZIPOffice Phone Home Phone
Arrival Date: Time:Departure Date: Time:(To Receive Convention Rate Reservation must be received by 4/1/12)
___ Single (1 person) $93 (plus tax) ___ Double (2 people) $113 (plus tax) ________________________ (Name of person sharing room)___ Check Enclosed
Credit Card ___ American Express ___ VISA ___ MasterCard ___ Discover
Credit Card No.Expiration Date:I understand that I am liable for one night’s room and tax, which will bededucted from my deposit or billed through my credit card in the event that Ido not arrive or cancel on the arrival date indicated. Reservations must beaccompanied by a deposit or an accepted credit card number and signature.
For reservations or cancellations, please call direct (502) 493-4685Signature Date
Mail this form and payment to: Ramada Plaza Hotel Attention: Reservations 9700 Bluegrass Parkway Louisville, KY 40299
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KHSADA Board of Directors
Nomination Form
The Kentucky High School Athletic Directors Association will conduct theAnnual Business/Election Meeting on Friday April 27, 2012 during theAnnual State Athletic Directors Conference. This Business/Election Meetingwill be conducted during the Closing General Session beginning at 10:30AM.
This is a most important meeting because we will conduct an election for theBoard of Directors for the West at Large (Regions 1-8) and Regions 1, 3, 5,7, 9, 11, 13, and 15. If you are interested (you may nominate yourself) inbeing placed in nomination for any of these positions, please complete theenclosed form and return to Arthur Ballard, CAA, Past President of theKHSADA by March 15, 2012.
PLEASE ENTER MY NAME ON THE BALLOT FOR:
BOARD OF DIRECTORS WEST AT LARGE _____
REGION _____
NAME
SCHOOL
ADDRESS CITYZIP
RETURN BY MARCH 15, 2012 TO:
ARTHUR BALLARD, CAA KHSADA PAST PRESIDENT ESTILL COUNTY HIGH SCHOOL 2075 WINCHESTRE ROAD IRVINE, KY 40336
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2012 KHSADA CORPORATE SPONSORS
Schedule Star (provider of the KHSADA Website)MPC Promotions, Inc. (provider of official KHSADAcloth wear)Ramada Plaza HotelUniversity of Louisville Athletics Department(Sponsor of the KHSADA Awards Banquet)Bluegrass Coca ColaPepsi AmericasSeneca Golf Course & Kevin GreenwellJimmie Reed & KHSCADr. Rudy J. Ellis Sports MedicineAll American PublishingKHSAA Coaches Education ProgramNFHS Coaches Education ProgramLouisville Awards (Official Awards Provider of theKHSADA)
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KHSADA Conference Non Profit Org.1730 Griffin Gate Road U. S. Postage PaidLouisville, KY 40205 Louisville, KY Permit No. 1188
