Super Series

Certificate of Insurance Request Form for Additional Insured

(Eligible Add. Insureds: Tournament Hosts, Field Locations, Landowners or Sponsors)

* Denotes Required Fields
Enter Team# (NOT Certificate # !) *
Team Name *
Your Name
Your Email
Additional Insured Name *
Additional Insured Address *
Additional Insured City *
Additional Insured State *
Additional Insured Zip *
Email address / Certificate delivery *
Field Location
Sponsor
Fax Number