RDC Venue Insurance Request Form
Please complete this form in full and allow 7 - 10 days turnaround.  Ensure you fill out all the applicable spots; your league name and address, name and full address of venue, email address of who will need a copy from insurance company. Please ask the venue you are using if they require you to add them or anyone else as "additional insured". If so, add the name, address, and postal code information into the online form.

Sign in to Google to save your progress. Learn more
Email *
Please add any other email addresses here that the certificate needs to be sent to once completed. *
What is the name of your league - Full Legal Name *
What is the full mailing address of your league, city and postal code (needed for the certificate) *
Name of Venue, full address, city and postal code required on the Certificate.
Please ask the venue you are using if they require you to add them or anyone else  as "additional insured".  If they do add that information here. (Name, address, postal code)
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of Roller Derby Canada Services - RDC. Report Abuse