Certificate of Insurance Request Form: Swim Alberta Association
This form is only used if a facility requests to be named on the Certificate of Insurance.
Please allow three weeks prior to your event for processing time. Thank you.
Club Contact Name
Club Contact Phone
Club Contact E-mail
Details of Event (What are you doing? Where are you going? Who's attending?)
Dates, if Applicable
Times, if Applicable
Numbers of: Coaches
Please list all chaperones, if applicable
Requesting Facility Information
Facility Contact Name
Please upload a copy or scan of your contract.
A scan of your contract MUST be included with this form.
Date of Submission: