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Insurance Forms

Certificate of Liability (COI) Form

Certificate of Liability Insurance Request Form

Note: Must be submitted by team or club’s home association to insurance@ntxsoccer.org

 

Youth Claim Forms

Youth Injury Claim Form 20/21 - English

Youth Injury Claim Form 20/21 - Spanish

 

Adult Claim Forms

Adult Injury Claim Form 21/22 - English

Adult Injury Claim Form 21/22 - Spanish

 

Additional Insurance Forms:

Fidelity Bond Application

NTSSA Auto Rental Program

25k Player Insurance Coverage Request Form

 

Referee Injury Claims

Your age does not matter. You will use the form based on the type of game you refereed.

If a youth game, use the youth claim forms. If Adult game, use the adult claim form.

Instead of a roster or coach letter, you will have the league or tournament admin/director provide a statement and game card.

 

 

Please email any questions to insurance@ntxsoccer.org

 
 
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