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2019-2020 IEA EVENT
INSURANCE REQUEST FORM

Insurance provided by Equisure, Inc.

*required fields

Coverage Info.
*
(if more than 1 day)
*
*
*
*

Insurance provided by Equisure Inc. and will include 2 Setup/take down days automatically.

* ($140 per day)

Approved Additional Insureds: Landowner or Facility or Co-Hosting Team(s).
Horse Providers are automatically included so no need to list them.

Additional Insured 1 (optional)
Additional Insured 2 (optional)
Additional Insured 3 (optional)
Additional Insured 4 (optional)
Additional Insured 5 (optional)

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