United States Specialty Sports Association Insurance Program
Note: There is an additional charge included for online processing.
Age Group determined by the age of the oldest child on the team at the time of purchase.
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Complete items below only if field/facility owner requests additional insured status. Below there are text boxes to add up to 6 field/facility owners. If you have more then 6 field/facility owners, please email requests for additionals to usssa@epicbrokers.com. Make sure you include your team name and USSSA insurance certificate number with the additional field/facility information. You will receive this confirmation number after paying online.
Additional Insured 1
Additional Insured 2
Additional Insured 3
Additional Insured 4
Additional Insured 5
Additional Insured 6
Please complete the missing fields of the form