CascadiaNow! · CascadiaStrong Event Insurance Request

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Hello amazing Project Leader. Use this form to request a Certificate of Additional Insured for an upcoming event.

This Certificate confirms that your venue will be covered by CN!'s general liability insurance policy during your event. There may be an additional cost of $30-$100 for this Certificate, depending on the event size. Fundraising events are generally exempt from this cost.

If you simply need proof of insurance, you do not need to complete this form. Contact projects@cascadianow.org.

Event Information

Name of Event:

Type of Event:

If this is a fundraising event, please make sure to specify.

Is your project the main host/coordinator for this event?

Yes

If "no," please describe your project's involvement with this event:

Name of Individual or Organization to be listed as Additional Insured:

Event Location:

Address Line 1

Address Line 2

City

State/Province

ZIP/Postal Code

Country

Additional Insured Mailing Address (if different from Event Location)

Address Line 1

Address Line 2

City

State/Province

ZIP/Postal Code

Country

Event Start Date:

(mm/dd/yyyy)

Event End Date (if applicable):

(mm/dd/yyyy)

Projected # of Attendees:

Projected Total Revenue:

Planned Activities:

Will there be a bounce house, trampoline or any other rebounding type of equipment at the event?

Yes

If "yes," what type of structure and how many?

If "yes," provide details of safety precautions during the use of the equipment.

Will food, beverages or alcohol be served?

Describe safety precautions if alcohol will be served:

Venue Contract

If you have entered into a contract with the venue that will host this event, please upload it here.

Other information:

Every event has some inherent risk. Use this space to let us know about any additional event elements not already included in this form that could pose additional risks. The more information you provide, the better we can guarantee the right level of coverage for your event.

Contact Information

Project Name:

Main Event Contact:

First Name

Last Name

Event Contact Email:

Verify Email