Skip to main content
Skip to main Navigation
Skip to Search
Contact Us
=
Main Sections
Home
Policy Limits & Coverage
RISK MANAGEMENT
BUY ONLINE
FAQS
SERVICE & SUPPORT
Your Current Location in the Site
Home
/
Online Orders
Urmia Camps Program Application
There was a problem with your submission.
Errors have been
highlighted
below.
The
Risk Management resources
on this site are intended to help answer the following questions. Your host University may also have additional materials and resources available through their Risk Management/EH&S/Legal or other departments.
All camps, including academic camps, must comply with all the below requirements.
1. Do you have a written safety program for your camp:
Yes
No
2. Do you have a written emergency plan for a weather emergency or other serious emergency:
Yes
No
3. Do you have a custodial parent or guardian sign a liability waiver for every child?:
Yes
No
4. Do you have certified CPR and First Aid Personnel immediately available to your camp?:
Yes
No
5. Are you using the
SafeKids Abuse Prevention Plan
, or do you have a similar, equivalent plan in place?
Yes
No
6. Have you adopted the Heads-Up Concussion education and prevention program found at the following site and with the following materials or do you have a similar plan in place?
Yes
No
Information can be obtained at:
http://www.cdc.gov/headsup/index.html
At minimum, review the following documents:
Fact sheet for coaches on concussion
Fact sheet for athletes on concussion
Fact sheet for parents on concussion
Clipboard with concussion facts for coaches
7. Do you have a Return-to-Play policy that requires any player who has sustained a head injury or who is suspected of having sustained a head injury to:
Visit a licensed health care professional for evaluation and clearance, AND
Sign (for youth players, have parent/legal guardian sign) a head injury information/awareness sheet before returning to practice or game play.
Yes
No
8. Do you give RPS Bollinger permission to send you insurance certificates electronically (via e-mail)?
Yes
No
CAMP INFORMATION SECTION
1. Select your type of camp?
Press "Control + Click" to select multiple sports.
Academic Camps
Archery
Badminton
Baseball
Basketball
Cheerleading
Cross Country
Fencing
Field Hockey
Flag Football
Non-Contact Football Conditioning
Golf
Handball
Hockey (Non-Checking)
Lacrosse
Racquetball
Rowing
Squash
Soccer
Softball
Swimming
Tennis
Track and Field
Volleyball
Water Polo
Wrestling
This activity requires individual underwriting in order for coverage to be bound. Please contact one of Bollinger's Sports Underwriters at
SportService@RPSins.com
or 800-446-5311. Thank you.
2. Is your camp being conducted at a university or college?
Yes
No
3. What state do you operate your camp:
Select a State
AL - Alabama
AK - Alaska
AZ - Arizona
AR - Arkansas
CA - California
CO - Colorado
CT - Connecticut
DC - District of Columbia
DE - Delaware
FL - Florida
GA - Georgia
HI - Hawaii
ID - Idaho
IL - Illinois
IN - Indiana
IA - Iowa
KS - Kansas
KY - Kentucky
LA - Louisiana
ME - Maine
MD - Maryland
MA - Massachusetts
MI - Michigan
MN - Minnesota
MS - Mississippi
MO - Missouri
MT - Montana
NE - Nebraska
NV - Nevada
NH - New Hampshire
NJ - New Jersey
NM - New Mexico
NY - New York
NC - North Carolina
ND - North Dakota
OH - Ohio
OK - Oklahoma
OR - Oregon
PA - Pennsylvania
RI - Rhode Island
SC - South Carolina
SD - South Dakota
TN - Tennessee
TX - Texas
UT - Utah
VT - Vermont
VA - Virginia
WA - Washington
WV - West Virginia
WI - Wisconsin
WY - Wyoming
4. Do you have off-site activities or trips?
Yes
No
5. Do you have any adult participants (other than staff) at your camp?
Yes
No