Democratic Party Liability Insurance Form
For special events run by clubs and county organizations.

Please fill out this form to the best of your ability. If you have any questions, please call the office at (858) 277-3367 or email andrea@sddemocrats.org.

What is your (club's) organizational name? *
Your answer
(Club) contact email address (receives liability certificate) *
Your answer
(Club) contact phone number *
Your answer
(Club) Address *
Your answer
Date requested *
Your answer
Will you be serving liquor at this event? *
Estimated attendance: *
Your answer
Date of event: *
Your answer
Time of event: *
Time
:
Name (or short description) of event: *
Your answer
Location of event: *
Your answer
Name of Additional Insured (i.e. landlord, property manager/owner, caterer, etc.): *
Your answer
Contact name of Additional Insured: *
Your answer
Address of Additional Insured: *
Your answer
Email of Additional Insured: *
Your answer
Phone of Additional Insured *
Your answer
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