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 *

Last Name *

E-Mail Address *

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 *

Team Name *

___________________________________________________________

ADDITIONAL INSURED INFORMATION

Name of Additional Insured (address needed as well) Contact Facility for correct information. *

Street *

City *

State *

ZIP / Postal Code *

Relationship location has to your team *

_____________________________________________________________________

Applicants Signature *

Date of completing application *

Submission Validation

Required

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.