Request a Quote for Team/League Seasonal Insurance

Breakdown of baseball participants by age groups (enter 0 if none)

Breakdown of softball participants by age groups (enter 0 if none)

Breakdown of soccer participants by age groups (enter 0 if none)

Breakdown of basketball participants by age groups (enter 0 if none)

Number of lacrosse participants by age (enter 0 if none)

Number of volleyball participants by age (enter 0 if none)

Number of Non-contact football participants by age (enter 0 if none)

Number of cheerleading participants by age (enter 0 if none)

Number of hockey participants by age (enter 0 if none)

Number of other participants by age (enter 0 if none)

DECLARATION FOR SUBMITTING

To the best of my knowledge and belief the information provided in this application, whether in my own hand or not, is true and I have not withheld any material facts. I understand that Non-disclosure or misrepresentation of a material fact will entitle the company to void the Insurance. I understand that submitting this Application does not bind me to complete the insurance but agree that should an insurance policy be issued, this Application and the statements made therein shall form basis of the insurance policy.

(By clicking “submit” below you are agreeing to the following statement)