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Apply for Insurance

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.

The below form works best using Google Chrome as your web browser.


Send a copy to my email
Chapter Information:
Your Name:
Your EAA Number:
Your Phone:
Your Email:
Your Chapter Name:
Event Details:
Event Name:
Event Start Date:
Event Start Time:
Event End Date:
Event End Time:
Recurring Event?
Recurring Event Description:
Rain Start Date:
Rain End Date:
Event Airport ID:
Facility Name:
Event Address:
Your Chapter's Role:
Your Chapter's Role:
Primary Sponsor?
Primary Sponsor Name:
Primary Sponsors Role:
Additional Insureds:
Additional Insured?
Additional Insured #1:
Insured #1 Role:
Insured #1 Items/Products:
Additional Insured #2:
Insured #2 Role:
Insured #2 Items/Products:
Contracts/Leases/Agreements:
Contracts, Leases or Other Agreements?
Contracts/Leases/Agreements Description:
Vendors/Exhibitors Participants?
Number of Vendors/Exhibitors Participants:
Fee per Vendor/Exhibitor:
Attendance/Activities:
EAA Member Attendance:
General Public Attendance:
Event Activities:
*Other Explanation:
Event Vehicles:
Automobiles (cars and trucks):
Buses:
Tractors and Wagons:
Golf carts, gators, motorcycles,
scooters, ATVs, etc:
Other:
Vehicle use explanation:
Additional Information:

Be Aware

Please pay your premium before the event takes place to keep your chapter current with EAA.

EAA Event Insurance Request Form.

Find Your Chapter!
Event Information
Recurring Event?
Yes     No
Describe when this event recurs. Note: All aspects of the event must remain the same.
(300 characters max)
Rain Start Date
(mm/dd/yyyy)
Rain End Date
(mm/dd/yyyy)
Event Airport ID
Airport Lookup (US & Canada only)
Facility Name
Street Address 1
Street Address 2
Your Chapter's role in this Event
Sole Organizer
Chapter is the only organization involved in the planning and conduct of the event.
Participant
Chapter will provide an activity (i.e. breakfast, lunch, Young Eagles, Chapter display) at an insured event sponsored by another organization.
Note: in order to participate in another organization’s event, a certificate of insurance from the primary sponsor may be required.
Co-mingling, co-sponsoring, or joining with another organization to share operational responsibility of an event is not permissible.
Is the chapter the primary sponsor?
Yes     No
Who is the primary sponsor?
What will they provide at the event (role/activities)?
(300 characters max)
Is any person or organization requesting additional insured status under this insurance?
Yes     No
Only facility owners are eligible for additional insured status.
Please list any person or organization requesting additional insured status under this insurance:
Name
Address
City, State, Zip
Role*
* Role in the event (ex: owner of airport, FBO providing use of hangar space, etc.)
List all items or products that have additional insured will sell at this event.
Items/Products
(150 characters max)
Name
Address
City, State, Zip
Role*
* Role in the event (ex: owner of airport, FBO providing use of hangar space, etc.)
List all items or products that have additional insured will sell at this event.
Items/Products
(150 characters max)
Will the chapter sign any contracts, leases or other agreements related to this event?
Yes     No
Please forward any agreements, permits, contracts, etc. to the Risk Management Department by clicking here. Please include your chapter number and valid email address.
Please list all contracts/leases/agreements that the Chapter has or will sign for this event.
Contracts, Leases or Agreements
(300 characters max)
Will any vendors or exhibitors be participating in this event?
Yes     No
Number of Vendors/Exhibitors participating in your event
Fee per Vendor/Exhibitor
Estimate of Attendance:
EAA Members
General Public
Activities
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)
  • Airshow requiring Waivered Airspace
  • Anything with respect to waivered airspace
  • Balloon Breaking
  • Combined Eagle Flights and Young Eagles flight activities
  • Endurance Flights Involving Fuel Exhaustion
  • Flour Bombing
  • Night Airshows
  • Parachute Jumpers
  • Participation in an uninsured event
  • Pyrotechnics/Fireworks
  • Racing of any kind
  • Ribbon Cutting
  • Sale of Alcoholic Beverages
  • Simulated Aerial Combat
  • Wing Walking
The activities below in red are permitted, but require 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
Aircraft Static Displays
Aviation Exhibitors
Awards Banquet
Car, Motorcycle, Farm Equipment Display
Charitable Flights under CFR 91.146(b)
Cook-out
Demonstrations
Fly-bys (showcase-parade of flight; WAIVERED AIRSPACE PROHIBITED)
Fly-In
Flying Start (may include Eagle Flights)
Fly-Market/Parts Mart
Fly-Out
Food Vendors
Formation Flights
Hot Air Balloons
IAC Aerobatic Contest - IAC Chapters only
IAC Chapter Practice Day-IAC Chapters only
IMC/VMC Program
Meeting
Non-Aviation Exhibitors
Pancake Breakfast
Poker Run Event
Radio Controlled Aircraft Demonstrations
Ride/Hopping/Site Rides - Commercial Rules
Spot Landing Contest
Ultralight Pilot Proficiency Events
Workshops
Young Eagle Build & Fly
Young Eagle Rides
Young Eagle Workshop/Day Camp
Other

Additional
Please include the chapter number and a valid email address when requesting the following:
Chapter Insurance Guide Request
Young Eagle Pilot Guidelines Request
Will the chapter be using any ground vehicles (e.g. golf carts, scooters, cars, trucks, etc.) to support the event?
Yes     No
Input the number of vehicles by type and how they will be used during the event
(Please provide a certificate of insurance on each vehicle)
Automobiles (cars and trucks)
Buses
Tractors and wagons
Golf carts, gators, motorcycles, scooters, ATVs, etc.
Other
Use
The space below may be used should you wish to include any additional information.
(1000 characters max)
Agree to Terms

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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