April 26, 2016 Andre Boulay NYYL Event Insurance Request NYYL Insurance Request Use this form to request insurance coverage for your event from the National Yo-Yo League. Processing the request, providing the coverage, and communicating with the additionally insured can easily take two-weeks so please send in your request early. We can't always provide coverage for a last minute request. Organizers Name* First Last Organizers Email* Enter Email Confirm Email Name of the event:*Date of event* Hours of the event*This should include any setup and teardown time.Name of Event Venue*Detailed Event Location at the VenueUse this to give a specific location for the event. Example, if the event takes place in a mall, identify where specifically.Event Address* Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Name(s) to be listed on insurance document*This is the name of the business entity or person to be listed as 'additionally insured'.Exact wording of insurance requirements from venue*Please be very specific and detailed. If a document has been provided to you, it can be attached at the end of this form as well.Site Contact Information*Name of the person to whom the insurance information needs to be sent. Make sure you include full contact information (e-mail, phone, fax, mailing address, etc.) and how they request that the information be sent to them.FileIf there is a specific document to be included with the request, you may attach it for reference.