Certificate of Insurance Request Form

Please submit this form for any Certificate of Insurance needs regarding an event outside your Sunday gathering, such as a retreat, staytreat, special service, leaders' meeting. If you have questions, please email Josh.


Name *
Name
General Questions
How will you be collecting payment? *
Please make sure to use your parish account that is tied to the central Eventbrite and not an Eventbrite account you created. If using PushPay, follow up with Josh to set up your retreat account.
Do you plan on taking pictures and using them in TGC media productions? *
Includes the website, slides on Sundays, promotional materials for next year. If yes, make sure media release forms are in your waiver, especially for children.
Are cars being rented for this event? *
Note that liability insurance covers rented cars, and that by using your Amex, you can waive all other insurance coverage (besides driver coverage). However, if staff or parishioners are driving, these cars are not insured. If ride-shares are happening, this should be in your waiver.
Items for your Certificate of Insurance
This is the venue/location where you are holding the event. DO NOT JUST ENTER THEIR NAME AND ADDRESS. Ask your contact for the exact information on their insurance and list that below.
May be different than the certificate holder address/location
Date(s) of the Event *
Date(s) of the Event
Include all indoor and outdoor sports, especially water sports or activities with children
Will you have waivers signed by all attendees holding you harmless? *
Copies of our waivers can be found in your parish admin's Google Drive folder
Does the organization have their own insurance? *
If you are doing any sports activities where their staff provides oversight, we need to have their COI as well and be included as an additional insured.
Write TGC ONLY if it is a church member only event.
Does the certificate holder want to be listed as an additional insured? *
If yes, is this contractually required by the signed agreement you have? *
YOUTH OVERNIGHT RETREATS ONLY: *
The questions below only need to be answered if you answer yes to this
Is it co-ed?
Are background checks made on all chaperones/leaders/volunteers?
All chaperones or leaders must have completed background checks before any retreats.