Wheelchair & Ambulatory Sports, USA

Team/Event Waiver Form

Wheelchair & Ambulatory Sports, USA provides affordable insurance coverage for the United States Quad Rugby Association, Turning Point Clubs, sanctioned events coordinated by our Regional Sports Organizations and our Member Clubs who elect to pay for insurance coverage.  If you are a team representative or event coordinator of one of the above groups, please fill out and submit the Request for Certificate of Insurance.  Please note that we require 3 to 4 weeks to process your insurance requests.  If you are requesting insurance less than 15 business days before your event you will be assessed an expedited fee.  Please contact the WASUSA  office for assistance in determining the fee.

In addition to providing coverage for our Member Clubs who elect to pay for insurance, WASUSA can provide individual and onetime event insurance for a fee on a per-person and per-day basis.  If you are interested in obtaining individual or onetime event insurance, please contact the WASUSA office to discuss your insurance needs and the fee for your coverage. 

By completing and submitting this form, the team representative  or event coordinator agrees to have all participants sign the WASUSA Team / Event Waiver Form found in the “Forms:Organizational”  section of the WASUSA website. If the WASUSA Team / Event Waiver Form is not completed and returned to the WASUSA National Office, the club will be responsible for payment of any insurance claims arising from the event for which the Certificate Of Insurance has been provided.

All "expedite" fees, individual event, and onetime event insurance fees can be paid via the Paypal link below.

If you are interested receiving information on becoming a member club or receiving insurance coverage through WASUSA, please contact:

Ralph Armento

Director of Operations,
Wheelchair & Ambulatory Sports, USA
director@wasusa.org

After contacting the WASUSA office to validate eligibility and price of insurance needed download the COI request form here and fill it out in its entirety leaving the top section for the WASUSA office to complete.  If paying online click on the pay now button below and enter the amount to be paid then click on the update Totals button.  It is important that you put the receipt ID number you receive by email from PayPal on the form in the proper location.  This will be the verification of payment needed to process the insurance paperwork.  Once you have completed these steps click on the submit button and your email client will open with a message addressed to the WSUSA Office with the completed form attached.  Please include "COI" followed by the receipt number in the subject field so that it will be identified quickly as an insurance certificate request.

Please download the Directors' and Officers' Liability Insurance application here.