SCORA Fundraiser Approval Form

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PLEASE SUBMIT AT LEAST 2 WEEKS PRIOR TO EVENT.

Under SCORA's insurance policy, fundraisers cost $2.14 - $2.29/participant for non-athletic activities and $5.79 - $5.94/participant for athletic activities and are subject to the club submitting the Fundraiser Approval Form. If no form is submitted, there’s no coverage.

For any independent contractor that will be providing a service at the event, please ensure they provide you with a Certificate of Insurance that names the following as Additional Insureds: Southern California Outrigger Racing Association and (your club).

Email *

Your Name *

SCORA Club *

Name of Event *

Event Date *

YYYY

Event Time *

Type of Event *

Athletic

Non-Athletic

Approximate Number of Participants - OVER 18 *

This is the amount of Non-SCORA members attending the event

Approximate Number of Participants - UNDER 18 *

This is the amount of Non-SCORA members attending the event

Estimated Gross Receipts *

Event Location *

Is owner of the premises requiring Proof of Insurance? *

Yes

Is owner of the premises requiring a Certificate of Insurance? *

Yes

If so, what is the Name and Address of Additional Insured?

Any other verbiage that needs to be on the COI?

Is security being provided? *

Yes

Will food be provided? *

Yes

Are you using a caterer? *

Yes

If yes, are they insured?

Yes

Clear selection

Are you providing entertainment? *

Yes

If yes, are they insured?

Yes

Clear selection

Is liquor being sold or provided at no cost? *

Liquor is being sold

Liquor is being provided at no cost

Neither

If liquor is being sold, estimated liquor receipts?

Is there a limit on the amount of liquor that will be served to an individual?

Yes

Clear selection

Will anyone be monitoring the amount of liquor being served to an individual?

Yes

Clear selection

Fundraiser details (include equipment being used, event logistics, etc) *

Please be as descriptive as possible

A copy of your responses will be emailed to the address you provided.

Submit

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