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Please complete the following Insurance Request form a minimum of 30 days prior to the event. The form is not required for normal monthly meetings.

Once the form is submitted, you have the opportunity to print a copy for your records. After the request has been reviewed and approved, you will receive a confirmation e-mail and certificate of insurance.

If the Risk Management Office requires additional information they will contact you directly prior to the event being processed and approved.

If you have any questions or we can be of help in any way, please contact Risk Management at: 920-426-6106, (800) 236-4800 Ext. 6106 (M-F 8:15am – 5:00pm) or chapterinsurance@eaa.org.

EAA Event Insurance Request Form. Bold fields are required.
Your Name:
Your EAA Number:
Your Phone Number:
Your Email Address:  
Your EAA Chapter:
Chapter Position:

Event Name:  
Event Start Date: (mm/dd/yyyy)
Event End Date: (mm/dd/yyyy)
Recurring Event?
Number of set-up days:
Number of tear-down days:
Rain Start Date: (mm/dd/yyyy)
Rain End Date: (mm/dd/yyyy)

Event Airport ID:
Facility Name:
Street Address 1:
Street Address 2:
City:  
State/Province:

Your Chapters role in this Event
Chapter is the only organization involved
in the planning and conduct of the event.
Chapter will provide an activity (i.e. breakfast,
lunch, Young Eagles, Chapter display) at an insured
event sponsored by another organization.
Please describe in detail, including careful
clarification of Chapter’s role in planning,
meetings, revenue, and promotion. Provide any
pertinent additional information
If Other,
please describe:
(300 characters
max)

Co-sponsoring or co-mingling with another organization to hold an event is not permissable.

Is the Chapter the primary sponsor?

Is any person or organization requesting additional insured status under this insurance?

Will the chapter sign any contracts, leases or other agreements related to this event?
Please forward any agreements, permits, contracts, etc. to the Risk Management Department by clicking here. Please include your Chapter number and valid email address.

Will any vendors or exhibitors be participating in this event?

Estimate of Attendance:
EAA Members:  
General Public:  

THE FOLLOWING ACTIVITIES ARE NOT COVERED BY THIS INSURANCE AND ARE NOT
PERMITTED AT ANY EAA FLY-IN EVENT.
> Aerobatics - Paid or Unpaid(Does not include IAC contests) > Participation in an uninsured event
> Airshow requiring Waivered Airspace > Pyrotechnics/Fireworks
> Anything with respect to waivered airspace > Racing of any kind
> Balloon Breaking > Ribbon Cutting
> Endurance Flights Involving Fuel Exhaustion > Sale of Alcoholic Beverages
> Flour Bombing > Simulated Aerial Combat
> Night Airshows > Wing Walking
> Parachute Jumpers

The activities below in red are permitted, but requires a certificate of insurance from the entity responsible listing your chapter, its officers, members, directors and volunteers as an additional insured. Please call our Risk Management office for details or questions.
Please check all activities your chapter is responsible for at the event:
Aircraft Manufacturer Demonstration Rides Formation Flights
Aircraft Static Displays Hot Air Balloons
Aviation Exhibitors IAC Aerobatic Contest - IAC Chapters only
Awards Banquet IAC Chapter Practice Day-IAC Chapters only
Car, Motorcycle, Farm Equipment Display Non-Aviation Exhibitors
Cook-out Pancake Breakfast
Demonstrations Poker Run Event
Eagle Flights Radio Controlled Aircraft Demonstrations
Fly-bys (showcase-parade of flight) Ride/Hopping/Site Rides - Commercial Rules
Fly-In Spot Landing Contest
Fly-Market/Parts Mart Ultralight Pilot Proficiency Events
Fly-Out Workshops
Food Vendors Young Eagle Rides
 Other:

Please include Chapter number and a valid email address when requesting the following:



If you are interested in Eagle Flight Ride Guidelines information please fill out this form.

Will the chapter be using any ground vehicles (e.g. golf carts, scooters, cars, trucks, etc.) to support the event?

The space below may be used should you wish to include any additional information.
(1000 characters max)

By selecting "Yes" below the submitter declares that to the best of his/her knowledge
and belief that the statements set forth herein are true and that they have been authorized by
the Chapter to request insurance for this event.

Please be advised, incomplete or inaccurate information may impair insurance coverage. This
application does not commit the insurers or EAA to any liability until the company agrees to
effect this insurance.

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