ADULT TEAM REGISTRATION CERTIFICATE REQUEST

There was a problem with your submission.

Errors have been highlighted below.

Important :

I hereby certify that my Team(s) and/or League is currently registered with USA Softball and compliant with their roster rules.
Check to agree.

Instructions

To request a certificate of insurance, please complete the information below, indicate the USA Softball Association/Commissioner you registered your Team(s) and/or League with and click on "Submit to Commissioner for Approval."
Once approved, you will be sent an email with your certificate(s).

Please indicate the type of certificate you are requesting:

Certificate type Proof of Insurance
Additional Insured
Proof of Insurance and Additional Insured

Registered Name

USA Softball Registered Team, League, or Tournament Name
Add Team Names to Certificate (optional)
Remove Team Names from Certificate
Team Name

Additional Insured Information

Certificate Holder Name

Are you hosting a tournament? Yes
No
Please click on dates below for Each Day of your tournament.

Days: 0
Dates:
Weeks: 0

Certificate Holder Address:
Certificate Holder Address 2:
Certificate Holder City:
Certificate Holder State:
Certificate Holder Zip Code:
Add More Additional Insureds

Additional Insured 2
Certificate Holder Name

Are you hosting a tournament? Yes
No
Please click on dates below for Each Day of your tournament.

Days: 0
Dates:
Weeks: 0

Certificate Holder Address:
Certificate Holder Address 2:
Certificate Holder City:
Certificate Holder State:
Certificate Holder Zip Code:
Add More Additional Insureds

Additional Insured 3
Certificate Holder Name

Are you hosting a tournament? Yes
No
Please click on dates below for Each Day of your tournament.

Days: 0
Dates:
Weeks: 0

Certificate Holder Address:
Certificate Holder Address 2:
Certificate Holder City:
Certificate Holder State:
Certificate Holder Zip Code:
Add More Additional Insureds

Additional Insured 4
Certificate Holder Name

Are you hosting a tournament? Yes
No
Please click on dates below for Each Day of your tournament.

Days: 0
Dates:
Weeks: 0

Certificate Holder Address:
Certificate Holder Address 2:
Certificate Holder City:
Certificate Holder State:
Certificate Holder Zip Code:
Add More Additional Insureds

Additional Insured 5
Certificate Holder Name

Are you hosting a tournament? Yes
No
Please click on dates below for Each Day of your tournament.

Days: 0
Dates:
Weeks: 0

Certificate Holder Address:
Certificate Holder Address 2:
Certificate Holder City:
Certificate Holder State:
Certificate Holder Zip Code:

Your Information

Your First Name:
Your Last Name:
E-mail Address: (only ONE email address)
E-mail Address Confirmation:
Phone:
Address
Address 2
City
State
Zip Code

Your Commissioner

USA Softball Commissioner Association:

ADULT TEAM REGISTRATION CERTIFICATE REQUEST

There was a problem with your submission.

Instructions

Please indicate the type of certificate you are requesting:

Registered Name

Additional Insured Information

Additional Insured 2

Additional Insured 3

Additional Insured 4

Additional Insured 5

Your Information

Your Commissioner

Toll Free:

Fax: