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INSURANCE FORMS AND INFORMATION


Member Clubs are covered by insurance policies as part of their member benefits.  Clubs receive secondary medical coverage for players and coaches as well as  liability coverage for property owners; Directors and Officers Insurance for not for profit club boards and liability insurance for the coaches.  More information on the insurance coverage can be found below.

Employee/Volunteer Dishonesty Bond (PDF) 

Youth Program Insurance Forms

20167-18 Indiana Soccer   Insurance Summary 

2017 - 18 Indiana Soccer YOUTH or YOUTH COACH Medical Claim Form (PDF) -
Insurance Claim Instructions
Please mail to our new address: 
19000 Grand Park Blvd   Suite J
Westfield IN 46074

Travel Assistance Flyer

Adult Program Insurance Forms
 
Indiana Soccer ADULT  Medical Claim Form (PDF)
Please mail to our new address: 
19000 Grand Park Blvd   Suite J
Westfield IN 46074

Indiana Soccer U-20 ADULT Medical Claim Form (PDF)
Please mail to our new address:
19000 Grand Park Blvd  Suite J
Westfield IN  46074

USASA Claim Filing Instructions
USASA  Medical Coverages
USASA Medical Policy U20 League

NEW!!! Insurance Waiver form for all USASA participants
Must be completed before play or added to the organization's online registration form  and signed digitally

USASA 15-16 Liability Insurance Summary
USASA Directors and Officers Liability
2015-16 D&O Insurance form - must be completed each year by each league
USASA Optional Coverages
 
En Español

INSTRUCCIONES PARA PRESENTACIÓN DE RECLAMACIONES DE PÓLIZAS DE ACCIDENTE DE USASA
USASA Cobertura Medica
USASA Cobertura de Responsabilidad

 
 
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