Katy Insurance Agency Personal Insurance Business Insurance Sports Insurance Manage Your Policy
Secured by SSL

Additional Insured Requests


Please complete this form, if your team ALREADY has coverage and you are NEEDING TO ADD an additional insured (field for practice and/or games).

TEAM INFORMATION
First Name
Required
Last Name
Required
E-Mail Address
Required
STADIUM INSURANCE DOES NOT APPLY TO "bodily injury" to any person while practicing for or participating in any sports or athletic contests or exhibition that you sponsor. In simple terms, injuries to players are not covered. This also includes, but not limited to, coaches, trainers or cheerleaders.
League Name
Required
Team Name
Required
___________________________________________________________
ADDITIONAL INSURED INFORMATION
Name of Additional Insured (address needed as well) Contact Facility for correct information.
Required
Street
Required
City
Required
State / Province
Required
ZIP / Postal Code
Required
Relationship location has to your team
Required
_____________________________________________________________________
Applicants Signature
Required
Date of completing application
Required
Submission Validation
Required
CAPTCHA
Change the CAPTCHA codeSpeak the CAPTCHA code
 
Enter the Validation Code from above.
Important Notice
Any submissions or payments made via this website do not constitute a binding agreement to your policy or coverages. Changes and payments to policies are not effective or binding until you, or any party involved, receive official notice from either your insurance agent, or your insurance company. If you have any questions, please feel free to contact us.

Per the terms of our online privacy policy we will not resell your information to any third-party.
Secured by SSL
Powered by Project CAP
Home PageAbout UsContact Us