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California Triathlon General Liability - Accident Coverage
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* Indicates required question
Email
*
Your email
Race Name
Your answer
Race Date
*
MM
/
DD
/
YYYY
Race Location
*
Your answer
Number of Race Participants - estimated
*
Your answer
Do you agree to make a final report of the actual number of participants and pay the appropriate premium charge?
*
Yes
Business Name
*
Your answer
Race Director Name
*
Your answer
Phone Number
*
Your answer
Address
*
Your answer
City
*
Your answer
State
*
Your answer
Zip Code
*
Your answer
Website Address (URL)
*
Your answer
Is your company a California Triathlon Affiliate? (Executed the California Triathlon Affiliation Agreement)
*
Yes
No
Will all participants sign the Cal Tri Assumption of Risk, Waiver of Liability, and Indemnification Agreement?
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Yes
No
Does the Property Owner Require a Certificate of Insurance or Endorsement(s)? If yes, please provide: Name, Address, and any special verbiage requirements and/or endorsements in comments section.
*
Yes
No
Comments
*
Your answer
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