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INSURANCE REQUEST FORM

use this format: 15556667777 with no spaces.

Type of Insurance Certificate
Named
Generic

The facility will specify if they need a name or generic certificate.

Start Date
Month
Day
Year

Date of event, or starting day of a range of dates for ongoing meetings.

End Date
Month
Day
Year

For one day events, start and end date are the same. For club meetings with a range of dates, simply enter the date of the last meeting.

Insurance - Club Generic
Club Generic$206.28

Stoa payments are processed through Stripe, an industry-standard vendor. Stripe charges Stoa a small fee for each credit card transaction. Consequently, your card will be charged $200 (club website fee) + $6.28 (processing fee) = $206.28.

Insurance - Club Named
Club Named Insurance$257.77

Stoa payments are processed through Stripe, an industry-standard vendor. Stripe charges Stoa a small fee for each credit card transaction. Consequently, your card will be charged $250 (club website fee) + $7.77 (processing fee) = $257.77.

Insurance - Tournament Generic
Tournament Generic Insurance$103.3

Stoa payments are processed through Stripe, an industry-standard vendor. Stripe charges Stoa a small fee for each credit card transaction. Consequently, your card will be charged $100 (club website fee) + $3.30 (processing fee) = $103.30.

Insurance - Tournament Named
Tournament Named Insurance$154.79

Stoa payments are processed through Stripe, an industry-standard vendor. Stripe charges Stoa a small fee for each credit card transaction. Consequently, your card will be charged $150 (club website fee) + $4.79 (processing fee) = $154.79.

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