Request edit access
Insurance Request Form
This form is used to request insurance for Special Olympics Michigan area events
Area Location
Your answer
Name of event *
Your answer
Event location Name *
Your answer
Event location address *
Your answer
Who is additionally insured?
Your answer
Starting Date of Event *
MM
/
DD
/
YYYY
Ending Date of Event (same as start date if event is a 1-day event) *
MM
/
DD
/
YYYY
Start time of event *
Time
:
Type of event (fundraiser, competition, etc.) *
Your answer
Contact person *
Your answer
Contact person's phone number *
Your answer
Contact person's email address *
Your answer
Submit
Never submit passwords through Google Forms.
This form was created inside of Special Olympics Michigan. Report Abuse