Dixie Youth Application
In just a few clicks, get an instant online quote and then you may continue to purchase coverage using an online check or credit card and receive certificates immediately!
Note: The following checks cannot be used online: money orders, cashier checks or warrants.
Only one (1) application is needed per policy year. Any additions or deletions of teams must be submitted via the Add/Delete Form below. Otherwise, teams may not be properly added to your policy.
- Recover verification of coverage documents to print Add/Delete Form
Start The Application
The submission of this application does not guarantee coverage even though you will immediately receive an email confirming that your payment has been submitted, and a second email evidencing Proof of Coverage subject to review of your electronic submission by Sadler & Company. In order to participate in this program your league must be franchised with Dixie Youth Baseball, Inc. or have an application pending.
I understand that all Premiums & Taxes are fully earned at inception and there are no provisions for cancellations or refunds.
I further acknowledge that I have reviewed all coverage plan descriptions for each policy (see Print Application) 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 us to select Accident (Medical Expense), General Liability, Directors & Officers Liability, Crime, and Equipment. 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.
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 email@example.com.
Coverage starts January 1, 2017, or on the date this enrollment form and premium payment are received by Sadler & Company, Inc. whichever is later, and continues to January 1, 2018. Exception: "All Star Tournament Team(s) Only" coverage cannot start prior to June 1, 2017.
We hereby enroll for Blanket Accident Insurance coverage underwritten by ACE American Insurance Company. We understand that insurance will be in force as of the Effective Date indicated above, provided the enrollment form is accepted by Sadler & Company, Inc. and the required premium is received by Sadler & Company. We acknowledge that we have read, understand and agree to the terms and conditions of coverage as detailed in the Blanket Accident Insurance Plan Description. It is a crime to provide false or misleading information to an insurer for the purpose of defrauding the insurer or any other person. Penalties include imprisonment and/or fines. In addition, an insurer may deny insurance benefits if false information materially related to a claim was provided by the applicant. Since this policy contains an Excess Medical Expense Benefit, you must first file the claim with your existing insurance plans (including major medical) before we may determine what payments, if any, we owe.
Coverage starts January 1, 2017, or on the date this completed Enrollment form and premium payment are received by Sadler & Company, Inc., whichever is later, and continues to January 1, 2018. Exception: "All Star Tournament Team(s) Only" Coverage cannot start prior to June 1, 2017.
We hereby enroll for General Liability coverage underwritten by National Casualty Company. We understand that insurance will be in force as of the Effective Date indicated above, provided the enrollment form is accepted by Sadler & Company, Inc. and the required premium is received by Sadler & Company, Inc. when due. Acceptance of this insurance confirms our desire to obtain insurance through the ERS Risk Purchasing Group Association, Inc., domiciled in IL. We have read, understand and agree to the terms and conditions of coverage as detailed in the General Liability Plan Description. We understand that all premiums are fully earned at inception and there are no provisions for cancellations or refunds. Anyone who includes false or misleading information is subject to criminal and civil penalties.
WARNING: The General Liability policy requires that an "Excess" Accident policy with a limit of at least $100,000 be in force, otherwise General Liability coverage will be voided in the event of injury to a sports participant.
Coverage for sexual abuse and molestation will not apply unless the insured team or league implements the following requirements:
- Has a system in place to perform criminal background checks on paid and volunteer staff
- Has written procedures that include sexual abuse and molestation prevention
- Has written procedures that include a response plan for allegations of sexual abuse or molestation including a requirement that law enforcement be contacted.
Sadler Sports Insurance provides a one page document, that if adopted and implemented, will satisfy these requirements. See the Abuse/Molestation Risk Management Program (short-form) that is attached to this brochure. The brochure can also be found at www.sadlersports.com/riskmanagement.
- Directors & Officers Liability
PLEASE NOTE: If your organization has franchises in Dixie Youth Baseball, Dixie Boys/Majors Baseball, and/or Dixie Softball and the same governing board oversees all of them you will only need to purchase these policies one time each year. You do not need to purchase these policies under each program. If, however, there is a separate governing board for each program, then you would need to purchase the policies separately as the rates are "per governing board".
These policies 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.
NOTE: Certain weather conditions (ex: tropical storms and hurricanes) in your area may prevent us from binding Equipment coverage upon receipt of the application and premium payment. If this happens, we will make coverage effective as soon as the insurance company allows us to do so.
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.
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 correct.
I am aware that the insurance company expects accurate reporting for my premium calculation, and should my figures exceed my estimates during the coverage term I will make arrangements to pay the additional premium. 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 afterwards. Intentional misrepresentation or misreporting may jeopardize coverage.
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 and communications electronically, including but not limited to, certificates of insurance, verification of coverage, underwriting questions, coverage changes, renewal notices, non-renewal notices, cancellation notices, quarterly newsletters and important messages. You have the right to withdraw your electronic consent and to request paper copies of certain documents and communications. However, withdrawing electronic consent will greatly diminish our ability to provide service in a timely fashion.
If I do not get email containing my proof of coverage documents within 24 hours, I will follow-up with Sadler & Company immediately.
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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