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MEN'S BASKETBALL CHAMPIONSHIPS HANDBOOK - February 27 - March 1, 2022 California Pacific ...
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MEN’S BASKETBALL
  CHAMPIONSHIPS
       HANDBOOK
                               February 27 – March 1, 2022

     Hosted by the University of Antelope Valley * Lancaster, CA
MEN'S BASKETBALL CHAMPIONSHIPS HANDBOOK - February 27 - March 1, 2022 California Pacific ...
CALIFORNIA PACIFIC CONFERENCE BASKETBALL CHAMPIONSHIPS

CONTENTS
1.0    Tournament Directory               2

2.0    Dates & Deadlines                  3

3.0    Schedule / Bracket                 4

4.0    Maps                               5

5.0    Operations                         6    5.35   Practice Times          10
5.1    Alcohol Ban                        6    5.36   Pre-Game Timing         11
5.2    Artificial Noisemakers             6    5.37   Sportsmanship           11
5.3    Automatic Qualification / Format   6    5.38   Tickets                 11
5.4    Awards & Banquet                   6    5.39   Tobacco                 11
5.5    Balls – Spalding NAIA              6    5.40   Towels/Bench            11
5.6    Banners & Signs                    6    5.41   Travel Party Limit      11
5.7    Bench Assignments                  6    5.42   Uniforms                11
5.8    Cancellation of Tournament         6    5.43   Videotaping             11
5.9    Champions of Character             6    5.44   Web-Streaming           11
5.10   Character Service Project          7
5.11   COVID Protocols                    7    Appendix 1 Participant Forms   12
5.12   Coaches Conference Call            7
5.13   Credentials                        7    Appendix 2 PEC Diagrams        13
5.14   Drug Testing Consent Form          7
5.15   Game Times & Pairings              7    Appendix 3 UAV COVID Forms     14
5.16   Games Committee                    8
5.17   Game Programs & Rosters            8
5.18   Home Team Designation              8
5.19   Hospitality                        8
5.20   Hotel                              8
5.21   Laundry                            8
5.22   Locker & Team Areas                8
5.23   Media & Sports Information         8
5.24   Medical & Training Procedures      9
5.25   Merchandise                        9
5.26   Meetings: Mandatory                9
5.27   National Anthem                    9
5.28   Officials                          9
5.29   Parking                            9
5.30   Participant Limits & Lists         9
5.31   Pass Lists – None                  9
5.32   Player Introductions               9
5.33   Post-Game Procedures               10
5.34   Post-Game Interviews               10

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MEN'S BASKETBALL CHAMPIONSHIPS HANDBOOK - February 27 - March 1, 2022 California Pacific ...
CALIFORNIA PACIFIC CONFERENCE BASKETBALL CHAMPIONSHIPS

1.0 TOURNAMENT STAFF
CALIFORNIA PACIFIC CONFERENCE                     www.calpacathletics.com           @cal_pac

Commissioner                 Don Ott              dott@calpacathletics.com   510-460-9470 (o)
                                                                             510-432-7699 (c)

Sports Information           Matt Davis           sid@calpacathletics.com    916-505-6549 (c)

Officials Assignor           Wendy Dailey         wendy@sacorefs.net         831-905-2741 (c)

UNIVERSITY OF ANTELOPE VALLEY ATHLETICS
44055 North Sierra Highway, Lancaster, CA 93534

President                    Marco Johnson

Director of Athletics        Gary Dickerson       gary.dickerson@uav.edu     661-726-1911 x 139

Sports Information           Andre Harrell        andre.harrell@uav.edu      661-726-1911 x 170
                                                                             661-468-6984 (c)

Head Athletic Trainer        Jayme Wright         jayme.wright@uav.edu       661-723-6592

Athletic Trainer             Hector Gonzalez      hector.gonzalez@uav.edu    661-723-6592

Men’s Basketball Coach       Jordan Mast          jordan.mast@uav.edu        661-726-1911 x 103
                                                                             503-913-7341

CHAMPIONSHIP HOTEL
Best Western Desert Poppy Inn                                                661-418-0550
The championship headquarters hotel is the Best Western Desert Poppy Inn, near the Pioneer
Events Center at 2048 W. Avenue “I”. Qualifying teams are encouraged to utilize this hotel.

Teams shall make their own reservations directly with the hotel property as soon as a team
has qualified by requesting “Cal Pac Championships” room block. (661-418-0550).

KEY LOCAL NUMBERS

Lancaster Sheriff                                                            661-948-8466
Lancaster Fire                                                               661-723-8546

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MEN'S BASKETBALL CHAMPIONSHIPS HANDBOOK - February 27 - March 1, 2022 California Pacific ...
CALIFORNIA PACIFIC CONFERENCE BASKETBALL CHAMPIONSHIPS

2.0 DATES & DEADLINES
FEB 21 (Mon)     Men’s Basketball Selections – Committee Meeting following final games

FEB 22 (Tue)     Cal Pac All-Conference Team Nominations Due (12:00 Noon PST)

FEB 22 (Tue)     Zoom Conference for tournament qualifiers (head coach / administrator)
                 (1:00 PM PST / 2:00 PM MST)
LINK: https://us06web.zoom.us/j/81470087091?pwd=VWVMSXVMODVjNGt5anNYZ1hBRzNNdz09

FEB 22 (Tue)     Official participant list due to Cal Pac (4:00 p.m. PST/5:00 p.m. MST)

FEB 23 (Wed)     Coaches: All-Conference Awards Nomination Zoom (11:00 AM PST)

FEB 23 (Wed)     Cal Pac Awards Ballots Due (2 hours after Zoom meeting)

FEB 26 (Sat)     Practice Times: Seeds 3, 4, 5, 6

FEB 27 (Sun)     Cal Pac Men’s Basketball – First Round
                       Game 1:     2:00 p.m. PST                      #4 CSUM vs. #5 UCM
                       Game 2:     4:30 p.m. PST*                     #3 UAV vs. #6 BENU

FEB 28 (Mon)     Cal Pac Men’s Basketball – Semifinals
                       Game 3:     5:00 p.m. PST                      #1 USK vs. CSUM/UCM
                       Game 4:     7:30 p.m. PST*                     #2 SIM vs. UAV/BEN
                                               *or 30 minutes after previous contest, whichever is later

MAR 1 (Tue)      Cal Pac Men’s Basketball Championship Game                   7:30 p.m. PST

MAR 1 (Tue)      NAIA Qualification Deadline

MAR 11-12        Opening Round Games at Host Sites

MAR 17-22        NAIA Men’s National Championships – Kansas City, MO

                                                                                                      3
MEN'S BASKETBALL CHAMPIONSHIPS HANDBOOK - February 27 - March 1, 2022 California Pacific ...
CALIFORNIA PACIFIC CONFERENCE BASKETBALL CHAMPIONSHIPS

3.0 BRACKET
   2021-22 CAL PAC
   MEN’S BASKETBALL
   Host: University of Antelope Valley
   Lancaster, CA
   February 27 - March 1, 2022

                                #1 Seed

                                   Game 3
          #4 Seed                  Monday
                              Feb. 28 - 5:00 pm

           Game 1
           Sunday
      Feb. 27 - 2:00 pm

          #5 Seed                                 CHAMPIONSHIP
                                                      Tuesday
                                                   Mar. 1, 7:30 pm
         #3 Seed
                                                                      Champion

          Game 2
          Sunday
     Feb. 27 - 4:30 pm

          #6 Seed                  Game 4
                                   Monday
                              Feb. 28 - 7:30 pm

                                #2 Seed

   SCHEDULE - All games played at UAV Pioneer Events Center
   Feb. 27 (Sun) -        OPENING ROUND
   Game 1 - 2:00          #4 Seed vs. #5 Seed
   Game 2 - 4:30*         #3 Seed vs. #6 Seed

   Feb. 28 (Mon) -        SEMIFINALS
   Game 3 - 5:00          #1 Seed vs. Game 1 Winner
   Game 4 - 7:30*         #2 Seed vs. Game 2 Winner

   Mar. 1 (Tue) -         CHAMPIONSHIP
   Game 5 - 7:30          Championship game

   * No less than 30 minutes after Game 1 or 3                       All Times LOCAL

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CALIFORNIA PACIFIC CONFERENCE BASKETBALL CHAMPIONSHIPS

4.0 UNIVERSTY of ANTELOPE VALLEY / PIONEER EVENTS CENTER

                 Games/Practices at Pioneer Event Center
                 45000 Valley Central Way, Lancaster

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CALIFORNIA PACIFIC CONFERENCE BASKETBALL CHAMPIONSHIPS

5.0 OPERATIONS
5.1   Alcohol Ban
Alcohol shall not be permitted in the arena during the championship event.

5.2     Artificial Noisemakers
All forms of artificial noisemakers are prohibited in Pioneer Event Center (PEC). In-arena
sound systems, public address announcements, and any music are prohibited when the ball is
live or being made ready for play.

5.3    Automatic Bid & Format
The bracket for the champion shall be single-elimination in format and will be determined by
the California Pacific Conference commissioner. The top team in each of the three (3)
scheduling pods shall qualify automatically. Three (3) additional at-large teams will be chosen
by the Selection Team, as appointed by the Commissioner. After selection, the six teams wil
be seeded and the bracket established. The #1 and #2 teams shall receive a bye into the
semifinals. The two teams advancing to the championship game will receive the Cal Pac’s two
(2) NAIA automatic bids (if available). If only one bid is available, the winner of the
championship game shall advance to nationals.

5.4   Awards & Awards Banquet
Due to COVID considerations, no awards banquet will be held in 2022.

5.5   Balls
Spalding is the official basketball of the Cal Pac and the TF-1000 Legacy ball shall be used.

5.6    Banners & Signs
Only approved banners and signage may be displayed in the arena. The tournament manager
is authorized to approve, limit, or restrict any team signage regarding appearance and content.
No commercial identification may appear on any team signage.

The Conference signage shall be prominently displayed for maximum effect in the arena and
for online viewing.

5.7   Bench Assignments
The team with the better seed shall be the home team and shall occupy the bench to the
RIGHT of the scorer’s table, facing the court. Team benches will have a maximum of 20 chairs.

5.8     Cancellation of Tournament
If the tournament is not completed, the NAIA automatic bid(s) shall be awarded to the #1 & 2
seeds.

5.9   Champions of Character
Each team shall name a team Champion of Character recipient who will be honored at the
awards reception. The deadline for submission is February 23, at 12 Noon. A Champions of

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CALIFORNIA PACIFIC CONFERENCE BASKETBALL CHAMPIONSHIPS

Character announcement will be read prior to each game by student-athletes from the
competing teams.

5.10 Champions of Character Service Project
Due to COVID restrictions, no service project will take place in 2022. It is our hope to return to
this valuable project in 2022-23.

5.11 COVID Protocols
All members of each team’s travel party agree to abide by the COVID Protocols and other
campus protocols while on the University of Antelope Valley campus. All participants must
comply with the following testing and reporting guidelines for this event. It is the responsibility
of each institution’s athletics director (or designee) to complete and return the UAV Athletics
Attestation form (Appendix 3) within 24 hours of their team’s first contest.

              * Fully vaccinated & boosted – No testing required.
              * Unvaccinated / Unboosted –
                      - PCR test within 72 hours of the event.
                      - Antigen test within 24 hours of the event.

Each institution is responsible for acquiring and administering its own COVID tests.

Contract tracing for the event will follow the Cal Pac COVID guidelines for Winter 2022.

Face coverings must be worn at all times while in UAV indoor facilities.

5.12 Coaches Conference Call (Mandatory for Qualifying Teams)
A video conference for the six qualifying teams will be held on Tuesday, February 22, at 1:00
PM PST (2:00 PM MST), to review tournament procedures, rules and policies. Participation is
mandatory for the head coach and a designated administrator of each participating institution.
Use the following link to access the conference:
https://us06web.zoom.us/j/81470087091?pwd=VWVMSXVMODVjNGt5anNYZ1hBRzNNdz09

5.13 Credentials
Non-transferable credentials are required for team personnel to access the competition. Any
unauthorized use or redistribution shall result in confiscation and immediate dismissal from the
tournament. Teams shall have a maximum of 21 credentials issued to no more than 15 players
and 6 coaches/bench personnel. The AD, up to 2 Sports medicine representatives, and a
sports information director may also receive credentials, which are not counted against the
team maximum.

5.14 Drug Testing Consent Forms
Participating institutions shall assure that each student-athlete has signed a valid NAIA drug
testing consent form prior to the beginning of tournament play. Institutions must verify
compliance prior to competition.

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CALIFORNIA PACIFIC CONFERENCE BASKETBALL CHAMPIONSHIPS

5.15 Game Times & Pairings
Game times for the Sunday first round shall be 2:00 and 4:30 p.m. Game times for the Monday
semifinals shall be 5:00 and 7:30 p.m. The championship contest shall begin Tuesday at 7:30
p.m.

On Day 1, the #4 team shall play the #5 team in the first contest, followed by the #3 team
playing the #6 team.

On Day 2 #1 seed shall play the #4/5 winner in the first semifinal. The #2 seed shall play the
#3/6 winner seed in the second semifinal. If the order of games changed on Day 1, the order
shall also adjust on Day 2 to allow appropriate rest for the advancing teams.

The Conference and the Games Committee have the authority to adjust the game times and
assignments in order to accommodate religious observance requirements.

5.16 Games Committee
The Games Committee shall consist of a Cal Pac Conference representative (Commissioner of
AD Liaison) who may serve in abstentia, the host institution’s athletics director, and the
conference officials’ supervisor or the referee crew chief.

5.17 Game Programs & Rosters
The host institution shall prepare and distribute game programs or roster cards, which may be
done virtually, for each session of the championships. The host shall work with the
participating institutions to confirm accurate names, spellings, and uniform numbers. The host
may use electronic distribution methods for the general public.

5.18 Home Team Designation
The team with the better seed shall be the home team in all contests.

5.19 Hospitality
Grab and Go hospitality refreshments will be supplied in a designated area for credentialed
individuals. Appendix 2.

5.20 Hotel
Each team shall make its own housing arrangements.

5.21 Laundry
Teams are responsible for their own laundry arrangements.

5.22 Locker & Team Rooms
Each team shall have a private, clearly marked, space to serve as a secure dressing and
meeting room during their contest. The space shall be assigned by the conference based on
seed, although the host institution may use its usual area if qualified for the event. Appendix 2.

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CALIFORNIA PACIFIC CONFERENCE BASKETBALL CHAMPIONSHIPS

5.23 Media & Sports Information
Requests for media credentials shall be submitted to Antelope Valley sports information
director Andre Harrell (andre.harrell@uav.edu) Each institution’s SID shall provide an accurate
current roster, pronunciation guide, and biographical information to the championship host SID.

5.24 Medical & Training Procedures
The sports medicine department is located at the Pioneer Event Center, and will be open two
(2) hours prior to the start of the first contest. Sports medicine personnel will be available to
assist visiting team trainers. For specific support and needs, make prior arrangements by
contacting Jayme Wright at (435) 979-5239 (c) or Hector Gonzalez at (818) 447-7515 (c).

5.25 Merchandise
The Cal Pac and the host institution retain exclusive rights to souvenir products for the
championships. Participating institutions may not sell their own products during the event. The
host may have a separate area for its merchandise.

5.26 Meetings, Mandatory: Coach / Administrator
A mandatory pre-championships Zoom meeting shall take place on Tuesday, February 22, at
1:00 PM (PST). The head coach and an administrator from each qualifying team is required to
participate.

5.27 National Anthem
The national anthem shall be played or performed prior to the first game of each day of the
event. Additional performances may be added as determined by the tournament hosts.

5.28 Officials
NAIA certified officials shall be assigned by the Cal Pac basketball officials supervisor, and
shall be paid for by the host institution.

5.29 Parking
Team vehicles shall park in the designated area on the North side of the PEC. Appendix 2.

5.30 Participant Lists
Per NAIA postseason policy, teams shall be limited to a maximum of 15 players in uniform plus
a maximum of 6 coaches/bench personnel. A maximum of 21 team credentials will be issued.

A maximum of two (2) Certified Athletic Trainer(s), a Sports information staff member, and the
Director of Athletics/designee may also be credentialed, and do not count in the team limit.

The official participant list must be submitted by 4:00 p.m. on Tuesday, February 22, 2022, to
both the Cal Pac office and the host institution’s tournament director.

5.31 Pass Lists
There are no team pass lists for the event. Teams may purchase tickets for distribution.

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CALIFORNIA PACIFIC CONFERENCE BASKETBALL CHAMPIONSHIPS

5.32 Player Introductions – No Contact
For COVID considerations, “no-contact” player pre-game introductions will be used for this
event. The student-athletes from designated visiting team shall be introduced, followed by the
student-athletes from the designated home team. All players shall stay on their half of the court
for the pre-game introductions.

5.33 Post-Game Procedures
Teams in the first contest each day shall immediately clear the playing surface and bench area
to provide access for the next contest. Once the teams have cleared the floor, 30 minutes will
be displayed on the game clock. The countdown will begin immediately, or at such time which
will allow the second game to start on time. Teams in the second semifinal shall have at least
30 minutes of warm-up time, following time for the host institution to sanitize the bench areas.

5.34 Post-Game Interviews
In order to reduce contact, no mandatory post-game interviews will be held on Days 1 and 2.
Following the championship game, both teams shall make the head coach and two (2) key
players available for comments.

5.35 Practice Times
Teams shall have a maximum of one (1) hour practice time on the tournament court on the day
prior to and day of their competition. On the day prior to the tournament, the time slots shall be
assigned by the conference based on seed and travel schedule.

Saturday, Feb. 26           First Round Teams
3:15 – 4:15 p.m.            #4 CSU Maritime
4:30 – 5:30 p.m.            #5 UC Merced
5:45 – 6:45 p.m.            #3 Antelope Valley
7:00 – 8:00 p.m.            #6 Benedictine-Mesa

Sunday, Feb. 27             Shoot-Around – First Round Teams
9:00 – 9:45 a.m.            Game 1 – Lower Seed
10:00 – 10:45 a.m.          Game 1 – Better Seed
11:00 – 11:45 a.m.          Game 2 – Lower Seed
12:00 – 12:45 p.m.          Game 2 – Better Seed

1:00 p.m.                   Court Available for Game 1 Teams

7:00 – 8:00 p.m.            #1 Seed
8:15 – 9:15 p.m.            #2 Seed

Monday, Feb. 28             Shoot-Around – Semifinal Teams
10:15 – 11:00 a.m.          Game 1 – Lower Seed
11:15 – 12 Noon             Game 1 – Better Seed
12:15 – 1:00 p.m.           Game 2 – Lower Seed
1:15 – 2:00 p.m.            Game 2 – Better Seed
4:00 p.m.                   Court Available for Semifinal 1 Teams

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CALIFORNIA PACIFIC CONFERENCE BASKETBALL CHAMPIONSHIPS

Tuesday, March 1
11:00 – 12:30 p.m.          Better Seed Finalist
12:45 – 2:15 p.m.           Lower Seed Finalist
6:30 p.m.                   Court available for Championship teams

5.36 Pregame Timing
The championship host institution shall prepare and post a pre-game timing sheet for all game
days of the event. The sheet shall be visible in all team locker / meeting areas, at the scorer’s
table, media area, officials’ dressing area, and hospitality area.

5.37 Sportsmanship Statement
The official Cal Pac student-athlete values statement shall be read prior to every contest by
basketball student-athletes from representing the two competing institutions.

5.38 Tickets
Single session tickets are $10 adults / $5 children (under 12) and participating students with a
valid college ID. The All-Session Pass is $20.

5.39 Tobacco
No tobacco products of any kind are permitted. Smoking, vaping, or electronic cigarettes are
prohibited in the competition area.

5.40 Towels, Bench Equipment, Water
Each team must supply its own towels and equipment for the tournament. The host institution
shall provide cups and water for each teams’ bench.

5.41 Travel Party & Participant List
Teams shall have a maximum travel party of 21 individuals, made up of no more than 15
players, six (6) coaches/bench personnel. No substitutions in the categories are allowed.
Each institution may also have its sports information director, athletics director (or designee),
and up to two (2) certified athletic trainers receive credentials. These individuals do not count
against the institutional team maximums. Each institution must submit the official participant list
the Cal Pac commissioner (dott@calpacathletics.com) by the Monday prior to the event
(February 21, 2022). A fillable form will be sent to each qualifying institution’s AD.

5.42 Uniforms
The better-seeded team shall wear light uniforms. The lower-seeded team must wear a
uniform color which contrasts with the home team.

5.43 Videotaping
Teams may only videotape games in which they participate. Teams must supply all their own
equipment, including power supply, cables, and extension cords. The host shall video and post
all games to the Synergy system after each contest
5.44 Web-Streaming
All games will be streamed live on Stretch Internet with access through both the Cal Pac and
UAV websites.

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CALIFORNIA PACIFIC CONFERENCE BASKETBALL CHAMPIONSHIPS

APPENDIX 1 - PARTICIPANT LISTS
Forms are available on-line at www.calpacathletics.com/Championship_information

               BASKETBALL CHAMPIONSHIP PARTICIPANT* LIST

     No.   STUDENT-ATHLETES (Alphabetical Order) *Maximum 15   Uniform #   Position & Year

     1

     2

     3

     4

     5

     6

     7

     8

     9

     10

     11

     12

     13

     14

     15

                                                               Email       Cell Phone
           HEAD COACH

           ASSISTANT 1

           ASSISTANT 2

           ASSISTANT 3

           ASSISTANT 4

           ASSISTANT 5

           SPORTS MED 1

           SPORTS MED 2

           SPORTS INFO

    ADDITIONAL AD or ADMINSTRATOR:

                                                                                             12
CALIFORNIA PACIFIC CONFERENCE BASKETBALL CHAMPIONSHIPS

APPENDIX 2 – COMPETITION SITE DIAGRAMS & MAPS

                                                              13
CALIFORNIA PACIFIC CONFERENCE BASKETBALL CHAMPIONSHIPS

APPENDIX 3 – UAV COVID ATTESTATION FORM
UAV is committed to making the safety of our athletes and staff our main priority. Each of UAVs
competition sites have safety measures in place such as Covid-19 screening areas and designated
isolation areas for the safety of everyone. Teams will be notified of those areas prior to arriving at UAV.

Visiting Teams with games at the Pioneer Event Center will have access to the Athletic Training Room.
Visiting teams will need to have documentation from their home Athletic Trainer if treatment is
needed. Visiting Athletic Trainers should send notification to UAV Athletic Trainers prior to team
arriving to make sure adequate time is given for treatment. If travel is within 6 hours of competition
site, please fill out the CVF and Attestation prior to your teams departure from home campus. If it not
possible, please notify Jayme.wright@uav.edu and we will screen your team when they arrive.

Visiting Teams need to arrive 1.5 hours prior to game time to allow time for Covid-19 screening to take
place prior to warm-ups. There will be designated area where a UAV trained representative will
conduct the screening prior to entering the game area.

Due to Covid-19 guidelines, visiting teams will be required to bring their own water bottles. There will
be access to hand sanitizer, water coolers, and ice on the sidelines.
UAV sideline will have the following available: AED, Splints, First Aid Kit, Tape, Crutches, and other
medical supplies.

The following is a list of emergency/urgent cares in our area.

*AV Hospital                                         *Palmdale Regional Hospital
1600 West Ave J                                      38600 Medical Drive
Lancaster, Ca 93534                                  Palmdale, Ca 95331
(661)949-5000                                        (661) 382-5000

*Kaiser Permanente Urgent Care                       *High Desert Urgent Care
43112 15th Street West                               43839 15th Street West
Lancaster, Ca 93534                                  Lancaster, Ca 93534
(661) 726-2279                                       (661)945-5984

Any further questions, contact Jayme Wright MS ATC at jayme.wright@uav.edu or 661-723-6592
For Games hosted by the University of Antelope Valley, we require visiting teams to meet or exceed
the universities testing protocols. The University of Antelope Valley current requirements, which are
fluid based on local guidelines, include daily screenings for athletes and coaches. Viisiting Athletes and
staff must be screened prior to departure from their home facility, no mandatory testing at this time.

If not traveling with an ATC, please complete the UAV CVF as well as this attestation and send to the
UAV ATC prior to departure from your campus. If your travel is more than 6 hours or an extended road
trip, please let us know ahead of time and we will screen your athletes once they arrive on our campus.

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CALIFORNIA PACIFIC CONFERENCE BASKETBALL CHAMPIONSHIPS

Visiting Teams will not be allowed in the competition area until this document has been received by
UAV’s Athletic Trainer, Jayme Wright MS ATC (jayme.wright@uav.edu)

   Ø By Signing this document, you attest that your institution meets or exceeds UAV’s testing
     guidelines.
   Ø No participants have tested positive within the past 10 days.
   Ø No participant has been in contact with someone that has tested positive in the past 2 weeks.
   Ø No participant has been in quarantine or isolation in the past 10 days.
   Ø UAV AD and Head Athletic Trainer will be notified if visiting team has a positive test within 3
     days of visiting our campus.

INSTITUTION:_________________________________________________________________________

DATE:_______________________________

SPORT:___________________________________________

INSTITUTION HEAD ATHLETIC TRAINER:____________________________________________________
             OR
DIRECTOR OF ATHLETICS:_______________________________________________________________

DATE:_______________________________________________________________________________

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CALIFORNIA PACIFIC CONFERENCE BASKETBALL CHAMPIONSHIPS

Institution Name:_____________________________            Date:________________________
 Athlete Name/Jersey #      Date/Time            Temp   Symptoms Present            Cleared

Visiting Team’s ATC______________________________________        Date:___________________
Visiting Team’s Rep______________________________________        Date:___________________
Host Team’s Rep________________________________________          Date:___________________

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