SCORA COI Request Form (for non-SCORA Races)

Not all non-SCORA races require a COI, some make you purchase their race insurance. Please do your research and go to the race's website before filling out this form.

In order to be covered by SCORA's insurance, you must race and register as a SCORA club. If you decide to race under a different name (ex: California Masters, So Cal Wahines, etc.) you will not be covered.
Email address *
Your Name *
Your answer
SCORA Club *
You must be registered under this club name.
Your answer
Additional Insured *
This is the non-SCORA club or association that is putting on the race you are traveling to. The correct verbiage that they need should be on their website.
Your answer
Address of Additional Insured *
This is usually on the race website or it is the address of the association putting on the race.
Your answer
Race *
Your answer
Race Date(s) *
Your answer
Race Location *
Your answer
List the Crew Members and SCORA IDs
You must list all SCORA members in the crew for the COI to be processed
Malia Hohl - SC100
Kelly Schwartz - SC101
Bruce Schwartz - SC102
Mike Shandroff - SC103
Billy Whitford - SC104
Cheance Adair - SC105
Your answer
Additional Notes or Requests
Your answer
A copy of your responses will be emailed to the address you provided.
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