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KSYSA Insurance Banner

 

TO REPORT AN INCIDENT 

 

Until August 31st 2018, Integro was the official insurance program administrator for Iowa Soccer Association, Nebraska State Soccer Association, and Kansas Youth Soccer.

 

CLICK HERE to review insurance guidelines that Affiliate members should follow and a summary of the insurance program.  The information contained in the summary is intended to serve only as an outline of the various insurance coverage.  Reference will be made to the respective policies for complete details and the terms, conditions, limitations and exclusions of coverage.

 

The insurance risk manager is Integro Entertainment and Sports Insurance Experts (ESIX).

 

ALL INCIDENTS ON OR BEFORE AUGUST 31st, 2018

Click the link below to fill out your form.

Integro Incident Report Form

 

 

As of September 1st, 2018, Pullen Insurance Services is proud to be the official insurance program administrator for Iowa Soccer Association, Nebraska State Soccer Association, and Kansas Youth Soccer. 

 

CLICK HERE to review insurance guidelines that Affiliate members should follow and a summary of the insurance program.  The information contained in the summary is intended to serve only as an outline of the various insurance coverage.  Reference will be made to the respective policies for complete details and the terms, conditions, limitations and exclusions of coverage.

 

ALL INCIDENTS ON AND AFTER SEPTEMBER 1st, 2018

Click the link below to fill out your form.

Pullen Incident Report Form (Type In Version)

Pullen Incident Report Form (Write In Version)

 

Once you completed the Pullen Incident Report Form please mail or email to Kansas State Youth 

Phil Gomez

Director of Membership

1495 S, Mahaffie Circle

Olathe, KS 66062

pgomez@kansasyouthsoccer.org

 

 

 

CERTIFICATES OF INSURANCE - FOR TEAMS ONLY

 

Current certificates of insurance are effective from September to August of each year for registered affiliate members.  Certificates of insurance for the next seasonal year will be dated as such and should be available by the last week of August once ESIX has received the insurance information from the underwriters and coverage is bound with the state association.

 

If you are a KSYSA League Administrator, to submit a request for certificate of insurance please be sure you have the information below gathered together and submit your request using the google doc form link below.

 

Certificate of Insurance Request Form

 

Name of Affiliate Member League/Club

Name of League Administrator Making Request

Name of Location for Certificate (i.e., Swarner Park, USD 259)

Complete Address of Location (Street Address, City, State, Zip Code)

 

This email request should only be completed by a League Administrator, not by parents or coaches.

 

If you have not received the requested insurance certificate within 48 business hours, please contact us at

 

Kelly Morgan

Executive Assistant

913-782-6434 x 22

kmorgan@kansasyouthsoccer.org

 

 

 
 
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