Rates Effective: 1/1/2025 – 1/1/2026

Please enter the information below to complete the application for the Team Preferred Membership Benefits Program. Once you have entered the required information click the button below ‘Continue to Payment’ and you will be brought to the payment gateway.

Current step:1 - Teams
2 - Organization
3 - Contact
4 - Insured
5 - Issuance
Number of Teams Age Range Rate Total Premium
8 & Under $129.00 $0.00
10 & Under $126.00 $0.00
12 & Under $84.00 $0.00
14 & Under $94.00 $0.00
16 & Under $104.00 $0.00
18 & Under $109.00 $0.00
20 & Under $118.00 $0.00
23 & Under $118.00 $0.00
Adult $248.00 $0.00
Total Premium Due $0.00

Insured Teams

Team Name / Sanction Number Action

Additional Insured

(i.e.: field owners, municipalities, schools, parks, rec center, etc)

Additional Insured Name / Address Action

Premium is fully earned on the effective date of coverage. No pro-rata refunds will be made. I understand and agree that (a) if this application is accepted by the Company, coverage will begin on the date of acceptance or the date requested in the application, whichever is later, subject to payment of the required premium; and (b) Premium computation is subject to audit. Any person who, with intent to defraud or knowing that he/she is facilitating a fraud against an insurer, submits application or files a claim containing a false or deceptive statement is guilty of insurance fraud.

A convenience fee of 2.5% will be added to all transactions.