Please fill out this form if out are injured at a practice, game or scrimmage and need to have a Claim Submitted. 
Claims need to be filed within 30 days so we need to start paperwork right away. 

Even if you have no receipts to submit and are injured severely enough to submit a claim you MUST send in the claim form within 30 days. You can submit the receipts at a later date –but it is just important to start the claim. 

We will fill out the forms and email them to you within 24-48 hours, please fill out the forms and send them back to us as soon as possible.

We will then check all of the paperwork and submit them on your behalf. 

Email    Personal Injury Insurance Broker        General Liability Broker

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