Request For Insurance

Request For Insurance
If this is a single day event, just fill this date out and leave the "End Date of Event" below field blank
List like this: Firstname Last Name (rating)
First
Last
Note: while both should be, either manager or secretary must be an ODS member
Facility Address
City
State/Province
Zip/Postal
Country
ONLY IF DIFFERENT than the Facility Address above, address to mail insurance certificate
City
State/Province
Zip/Postal
Country
This is what will be published about your Event on the ODS Website Master Calendar. Include any special approvals, qualifiers, etc., details about entry (i.e. what form to use), etc.
Drop a file here or click to upload Choose File
Maximum upload size: 516MB
This will be attached to the ODS Website Calendar.
Use your mouse or finger to draw your signature above