WELS Districts Special Event Liability Insurance Request

"*" indicates required fields

This form must be submitted at least 90 days prior to the event to allow sufficient time to secure the necessary insurance coverage. The district is responsible for any additional insurance costs.

District*

Event name*

Event start date*

Event end date*

Number of youth attendees*

Number of adult attendees*

Event location*

Activities being held at this event*

High-risk activities (swimming, rock climbing, zip-lining, etc.) may increase coverage costs.

Upload any contracts and/or insurance requirements*

Drop files here or

Max. file size: 50 MB.

Reminder – All adult chaperones are required to complete a background check prior to the event. If the district is unable to conduct these checks, WELS Risk Management can facilitate them on the district’s behalf through our partnership with a trusted provider. Each background check will be $7 to $20, which is the responsibility of the district. Please reach out to risk management ([email protected]) with any questions.

Type of background check*

Contact Information

Contact name*

First Last

Contact e-mail*

Contact phone number*

Position in district

FOR APPROVER USE ONLY - Enter approver code

WELS Risk Management: [email protected] or 414-256-3260 | Privacy policy
Ref: Districts Special Event Liability Insurance Request