150 Des Moines Street
Des Moines, IA 50309-1836
Event License Number:
Application for an Iowa Wrestling Event License
This completed application and $100.00 non-refundable event license fee must be submitted to the Iowa
Division of Labor at the above address, no later than seven days prior to the event.
Only One Event per Application
Event Date Event Location Name
Event Location Address Event City
I have read Iowa Code Chapter 90A regulating the conduct of professional athletics and the Administrative
Rules of the Athletic Commissioner and will conform to their requirements in all respects.
I understand this license authorizes me to conduct this athletic event only on the date and place specified
I understand I must file an Events Receipt Report regarding attendance and receipts with the Athletic
Commission within 20 days after each event. The Events Receipt Report shall be accompanied by a check
payable to the Iowa Athletic Commission and a check payable to the Iowa Department of Revenue, sent to
Promoter’s Signature Date
Equal Opportunity Employer/Program
Auxiliary aids and services are available upon request to individuals with disabilities.
For deaf and hard of hearing, use Relay 711.
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