NSLPA Teams/Leagues/Associations Online Application
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I agree to the following:
The insurance agent placing coverage under this online enrollment holds a currently valid Property & Casualty insurance license in the state in which the insured sports organization is located.
In addition, I agree that I have reviewed the Detailed Coverage Description that can be found at https://www.sadlersports.com/wp-content/uploads/2019-AGENT-TLA-App.pdf.
I also hereby confirm that I have reviewed the Detailed Coverage Description with the insured, and that the insured has provided the answers to all of the questions on the enrollment form and authorized me to submit this enrollment form on their behalf. No commissions will be payable to the insurance agent placing coverage until Sadler & Company, Inc. has received the requested Agent/Broker forms that are listed on our website.
I understand that in order to qualify for these coverages, the sports organization must join the National Sports Lawsuit Protection Association (NSLPA) and pay a membership fee of $5.00 per year. Membership entitles my organization to a monthly email newsletter, risk management materials and access to the insurance program.
In the event that Sadler & Company determines that the applicant does not qualify for this program, has not accurately answered a question, or has tendered an invalid check or one with insufficient funds, it will immediately void all coverages as of the effective date and notify all certificate holders.
This program has been designed for U.S.-based teams, leagues, clubs and associations conducting youth or adult amateur sports activities. Coverage provided includes important liability protection for the organization, including its employees and volunteers, for liability claims arising out of its operations. For eligible sports and age groups reported to Sadler & Co, covered operations consist of your scheduled, sanctioned, approved, organized and supervised practices, try-outs, clinics, games, playoffs and tournaments in which you participate or you host. Coverage is also provided for your registrations, meetings, concession stand operations, parades in which you participate, picnics, award banquets and ceremonies and incidental fund-raising activities involving the sale of products, coupons, raffle tickets and services, such as: car washes, bake sales and coin drops, for those sports and age groups reported to us. Coverage is provided by a Carrier rated A+ (Superior) by A.M. Best Company.
I agree to the following:
Application for this plan may be made until 02-28-2020. After this date, new applications may be subject to changes in rates and coverages.
The submission of this enrollment form does not guarantee coverage. Completion of this enrollment form confirms your desire to obtain insurance through the Sports, Leisure and Entertainment Risk Purchasing Group (RPG). An RPG provides group purchasing power for similar risks resulting in potential advantageous coverage terms, competitive rates, risk management bulletins, and rewards for favorable group loss experience. An RPG administration fee may be charged. The submission of this enrollment form and/or acceptance of payment does not guarantee coverage. Certain operations are not eligible for coverage by this program. We reserve the right to decline any request for coverage
Sports Groups that are affiliated with the following organizations are not eligible for this program: American Amateur Baseball Congress, Babe Ruth/Cal Ripken Basbeball, American Youth Football, Dixie Boys Baseball, Dixie Softball, Dixie Youth Baseball, World Adult Kickball Association (WAKA), Babe Ruth Softball, US Youth Soccer Association, Soccer Association for Youth, USA (SAY Soccer).
All participants are required to be reported in your premium calculation, and a roster may be requested as verification.
The premium computation section must be completed as applicable. Please note that all rates are per participant per sport. Coverage applies for one full year from your effective date. For example: 5-15-19 to 5-15-20. If adding new participants throughout your policy year, please notify Sadler & Company prior to participation. The online enrollment is only available for Class B and Class C sports and not for Class A sports.
Costs are 100% fully earned and non-refundable once coverage begins. Coverage is contingent upon receipt of payment. No coverage will be deemed in effect until the accurate payment is received by Sadler & Company.
Organizations providing instruction, practice, and competition in the following sports and age groups are eligible for this program, with coverage to be provided based on Class A or Class B classifications.
- If your sport is not listed, contact Sadler & Co at 1-800-622-7370 for proper classification.
- If you have Class A, and Class B and/or Class C participants on the same team, you must use the Class A rate for all participants. Please complete the downloadable brochure.
- Class C Sports- High Risk Brain injury sports have the option to exclude coverage for brain injuries in order to receive premium credits. In order to receive credits, you must contact Sadler & Company directly at firstname.lastname@example.org.
CLASS A SPORTS
- Box Lacrosse
- Flex Football TM (age 20 & over)
- Ice Hockey
- In-line Hockey
- In-line Skating (speed)
- Lacrosse (age 20 & over)
- Power Lifting (age 20 & over)
- Roller Hockey (inline)
- Umpire Association for Class A Sports
- Water Hockey (age 20 & over)
- Water Polo (age 20 & over)
- Weightlifting (age 20 & over)
- Wrestling (age 20 & over)
CLASS B SPORTS (Low Risk Brain Injury Sports)
- Baton Twirling
- Bocce Ball
- Cross Country Ski
- Dance Team (19 & Under)
- Disabled Sports
- Drill Team (Age 19 & Under)
- Figure Skating
- Flag & Touch Football
- Frisbee/Frisbee Golf
- Handball (Team)
- Lacrosse (Age 19 & Under)
- Roller Skating
- Rope Skipping
- Running (5k or 10k)
- Scooter Hockey
- Speed Skating (ice)
- Stick Hockey
- Team Handball
- Track & Field (Excluding Javelin / Hammer)
- Ultimate Frisbee
- Umpire/Referee Associations for Class B Sports
- Water Polo (age 19 & under)
- Weightlifting (age 19 & under)
CLASS C SPORTS (High Risk Brain Injury Sports)
- Cheerleading (age 19 & under)
- Deck/Floor/Street Hockey
- Field Hockey
- Flex Footbal TM (age 19 & under)
- Lacrosse (age 19 & under)
- Roller Hockey (quad)
- Soccer (age 19 & under)
- Tackle and Contact Football (age 19 & under)
- Wrestling (age 19 & under)
- Umpire & Referee Associations for Class C Sports
See brochure for complete list of INELIGIBLE operations and policy EXCLUSIONS.
The minimum earned premium is listed within this enrollment form based on the limit of liability chosen. If the total calculated premium is less than the minimum earned premium, the premium due is the minimum premium.
In order to obtain coverage for Limited Hosted Tournaments, you must purchase the Amateur Sports Insurance Program and call Sadler & Company for the application and premium charge.
In order to obtain coverage for Camps & Clinics, you should visit our website at www.sadleragent.com/camps.php.
- Directors & Officers Liability
These coverages are available only if my league has purchased its General Liability coverage through Sadler & Company.
FOR THE DIRECTORS & OFFICERS LIABILITY POLICY: IMPORTANT NOTE: THE POLICY FOR WHICH APPLICATION IS MADE, IF ISSUED, WILL BE ON A CLAIMS MADE BASIS. THIS POLICY SUBJECT TO THE DECLARATIONS, INSURING AGREEMENTS, TERMS, CONDITIONS, LIMITATIONS AND AMENDMENTS APPLIES ONLY TO CLAIMS THAT ARE FIRST MADE DURING THE POLICY PERIOD OR THE DISCOVERY PERIOD IF EXERCISED.
The Crime Policy does not cover vandalism or theft of property by outsiders. If this coverage is desired, you must purchase coverage under the Equipment Section.
The Equipment Policy requires that all equipment valued $1,000.00 or more per item be individually scheduled with a brief description of the equipment and its replacement cost value. Please have this information available prior to completing the equipment application. (Itemized Inventory will be required at time of loss.)
NOTE: There is no coverage for losses caused by wind and/or storm surge on property located in Florida, property that is two (2) miles from the Eastern Seaboard (in states where there are barrier islands the starting point is the coastline not the barrier island), and ten (10) miles from the Gulf Coast.
For all three policies under optional coverages, coverage is effective only upon underwriting and acceptance by the carrier. All coverages expire one year after the effective date.
NOTE: If purchaser's coverage is non-renewed, the carrier shall endeavor, but shall not be required, to provide purchaser with prior written notice of non-renewal equal to the time allotted by purchaser's domiciliary state. By signing the application, purchaser acknowledged: (1) That this evidence of insurance (hereinafter "EOI") shall be non-renewed effective the expiration date; and (2) That, upon the expiration of purchaser's EOI, the carrier may offer a renewal, but reserves the rights, because of aforesaid non-renewal, to change the terms & conditions of coverage as compared with the expiring coverage.
Applicable in AL, AR, DC, LA, MD, NM, RI and WV - Any person who knowingly (or willfully)* presents a false or fraudulent claim for payment of a loss or benefit or knowingly (or willfully)* presents false information in an application for insurance is guilty of a crime and may be subject to fines and confinement in prison. *Applies in MD only.
Applicable in CO - It is unlawful to knowingly provide false, incomplete, or misleading facts or information to an insurance company for the purpose of defrauding or attempting to defraud the company. Penalties may include imprisonment, fines, denial of insurance and civil damages. Any insurance company or agent of an insurance company who knowingly provides false, incomplete, or misleading facts or information to a policyholder or claimant for the purpose of defrauding or attempting to defraud the policyholder or claimant with regard to a settlement or award payable from insurance proceeds shall be reported to the Colorado Division of Insurance within the Department of Regulatory Agencies.
Applicable in FL and OK - Any person knowingly and with intent to injure, defraud, or deceive any insurer files a statement of claim or an application containing any false, incomplete, or misleading information is guilty of a felony (of the third degree)*. *Applies in FL only.
Applicable in KS - Any person who knowingly and with intent to defraud, presents, causes to be presented or prepared with knowledge or belief that it will be presented to or by an insurer, purported insurer, broker or any agent thereof, any written statement as part of, or in support of, an application for the issuance of, or the rating of an insurance policy for personal or commercial insurance, or a claim for payment or other benefit pursuant to an insurance policy for commercial or personal insurance which such person knows to contain materially false information concerning any fact material thereto; or conceals, for the purpose of misleading, information concerning any fact material thereto commits a fraudulent insurance act.
Applicable in KY, NY, OH and PA - Any person who knowingly and with intent to defraud any insurance company or other person files an application for insurance or statement of claim containing any materially false information or conceals for the purpose of misleading information concerning any fact material thereto commits a fraudulent insurance act, which is a crime and subjects such person to criminal and civil penalties* (not to exceed five thousand dollars and the stated value of the claim for each such violation)*, *Applies in NY only.
Applicable in ME, TN, VA and WA - It is a crime to knowingly provide false, incomplete or misleading information to an insurance company for the purpose of defrauding the company. Penalties (may)* include imprisonment, fines and denial of insurance benefits. *Applies in ME only.
Applicable in NJ - Any person who includes any false or misleading information on an application for an insurance policy is subject to criminal and civil penalties.
Applicable in OR - Any person who knowingly and with intent to defraud or solicit another to defraud the insurer by submitting an application containing a false statement as to any material fact may be violating state law.
I understand that the insurance company, in determining whether to provide insurance coverage, will rely on the information contained in this form and all other information being submitted. I hereby warrant, represent and confirm that, to the best of my knowledge, all information provided is complete, true and accurate.
I am aware that the insurance company expects accurate reporting for my premium calculation. I understand that my books and records may be examined or audited by the insurance company at any time during the coverage period and up to three years thereafter. Intentional misrepresentation or misreporting may jeopardize coverage.
I understand that the premium is calculated per participant/per sport. If at any time during the policy year my organization adds additional players or additional sports, the additions must be reported in order for coverage to extend at the time of a claim.
I further acknowledge that I have reviewed all information provided with this enrollment form and understand the exclusions that apply, as well as the activities and operations for which coverage is not provided
I understand that this online enrollment provides the option for the organization to select General Liability/Medical Payments, Directors and Office, Crime, Inland Marine, Sexual Abuse & Molestation, Hosted Tournament Coverage and Premises Liability. However, Sadler offers other types of insurance policies that are not available on this online enrollment such as Workers' Compensation, Excess Liability, Property (building and contents), Event Cancellation, Cyber Risk, Business Auto, Professional Liability, etc. If I am interested in a quote for these other types of policies, I will need to inform Sadler in writing, email@example.com.
I understand that I will only receive electronic copies of insurance documents and will not receive paper copies.
I understand that the files contained in my proof of coverage email are important documents. Once these documents are received, I will review and make sure the documents contain the coverages requested and further agree to notify Sadler & Co., Inc. if the documents have any mistakes in coverages and/or limits. I am aware that because this coverage is written on a master policy, only the certificate of insurance and the verification of coverage will be provided. However, a copy of the master policy is available at any time by emailing a request to firstname.lastname@example.org .
If I do not get email containing my proof of coverage documents within 24 hours, I will follow-up with Sadler & Company immediately.
I acknowledge that my address below is correct and will update Sadler & Co., Inc. of any changes to this email in the future. I grant permission to Sadler & Co., Inc. to utilize this email address to send all documents electronically, including but not limited to, certificates of insurance, verification of coverage, underwriting questions, coverage changes, quarterly newsletters and important messages.
I acknowledge that I have read and understan the Electronic Disclosure and Consent in accordance with the Electronic Signatures in Global and National Commerce Act(15 U.S.C. 7001, et seg.)
If you've already purchased insurance with Sadler & Company and need to access to your verification of coverage documents or add an Additional Certificate click here to recover your information. The email address attached to your account will need to be supplied.
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