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Search for:
EVENT INSURANCE REQUEST
TLCA
2024-10-26T14:57:15-06:00
EVENT LIABILITY INSURANCE
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" indicates required fields
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Chapter Information
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Event Information
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Trail Ride Information
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Review
Liability insurance coverage for your TLCA sanctioned event is available to all TLCA chapters in good standing. Requests should be submitted at least one month prior to the event.
Name of Chapter
*
In order to be eligible for insurance your chapter must be in good standing.
*
I confirm that my chapter is in good standing and we have submitted our chapter in good standing form for the current year
Event type
*
For profit event
Not for profit event for a TLCA chapter
Do you require all event participants to have a TLCA membership?
*
Yes
No
Event Committee Members
*
Name of chapter member submitting this request
*
Email of chapter member submitting this request
*
Name of chapter member to receive invoice
*
Email of chapter member who will receive invoice
*
Name of Event
*
Start Date of Event
*
MM slash DD slash YYYY
End Date of Event
*
MM slash DD slash YYYY
Event Location
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Name of site
Event Location Address
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Street Address
City
State
Alabama
Alaska
American Samoa
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Guam
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Northern Mariana Islands
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
U.S. Virgin Islands
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
ZIP Code
Type of Event
*
Most events will be classified as a trail ride. If your event involves "wheels rolling" you should select trail ride.
Event Trail Ride
Rally or Swap Meet (non-moving event)
Other Event (trail clean up, etc.)
If other, please explain
*
How many total drivers/vehicles will register for your event?
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How many total participants will attend your event?
*
Coverages:
*
Liability Limits
$1,000,000 CSL
Additional Insureds and relationship (landowner/sponsor)
Vendor Notice
*
Please note that all vendors are required to provide their own liability coverage and are not covered under this event insurance policy.
I have read and understand that all vendors are required to carry their own liability coverage for this event
Are control vehicles and/or spotters used for unusually rough terrain?
*
Yes
No
Is a lead and/or tail vehicle used?
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Both lead and tail
Lead only
No
Is there some form of recognized communication between vehicles?
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Yes
No
What are you using for communication?
*
Are fire extinguishers readily available?
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Yes
No
Will your event take participants on public roads?
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Yes
No
Valid personal auto insurance is required for all events that involve public roads. Please explain your plan for verifying participant insurance.
*
Please confirm
*
I confirm that our event does not take place on public roads
Has authorization been given for the event to take place on the specified property?
*
Yes
No
If the vehicle is "open top" or "soft top," is a roll bar installed required for participants?
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Yes
No
Please provide the minimum age for vehicle operators? (16+ with valid drivers license required)
*
Please provide the minimum age for passengers? If passengers under 18 are allowed, please provide the appropriate precautions in place for all minors (IE: Applicable safety restraints/car seats are required as per state laws)
*
If a vehicle becomes stuck, what are the towing procedures? (Winch? Cable or rope? Are participants cleared away until the vehicle is freed?)
*
I hereby declare that the information provided is true and correct.
*
Signature
Review your information. Use the 'previous' link at the bottom of this page to go back and make changes.
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