Insurance Application Form

2020 OASA Insurance Application Form

Liability Insurance*
*Please ensure that the third-partybox below has been filled out, signed and dated. Failure to do this may delay your certificate

Number of Non-affiliated Teams (House League, Recreational, Select)

X $32.00 =

Number of Affiliated Teams (Teams playing in OASA Qualifier, Elimination or Provincial Tournaments)

X $29.00 =


If yes, YOU MUST provide the Legal Name(s) of any Third Party to be insured:
Please note the above MUST be filled in at the time of application if not additional fees may apply.

Sport Accident Insurance**
* *Accident Insurance is NOT available unless Liability Insurance has been purchased

X $43.00 =

X $37.00 =


(A)

+ (B)

= Total for all insurance (all prices include HST)

Team Names and Stats must be provided to the OASA Insurance Coordinator before May 15, 2020 or insurance claims may take longer or be denied. A breakdown of what is requested is on page 3 of this application.
This year we are only accepting cheques.
Pleasemake cheques payable to: O.A.S.A.
Please send to
Garry Waugh,
45 Earlscourt Crescent,
Woodstock, ON
N4S 5H2

Due to the increased riskin e-transfer frauds, this year we will only be accepting cheques. Please make cheques payableto the O.A.S.A., and send to:

Garry Waugh
45 Earlscourt Crescent
Woodstock, ON
N4S 5H2

OASA Insurance Coordinator
Telephone: (519) 537-5835
Fax: (519) 537-5835
Email: insurance.oasa@execulink.com

Please note that your insurance coverage and membership with the Ontario Amateur Softball Association expires on January 1 following the year in which your fees are paid.

POLICE RECORDS CHECK POLICY:
It is the policy of the OASA that a current (<=5 years old) Police Record Check -with a declaration signed yearly is required for any individual who is in a position of trust or authority while working with youth (under the age of 19).
It is the responsibility of each team, league or association to ensure that Police Record Checks have been completed.
PRIVACY ACT:
By providing the Ontario Amateur Softball Association (OASA) with your Association's information on this registration form, you are giving consent to the OASA to collect and use your Association's information for the following purposes: receiving communications from the OASA and Softball Ontario, the publication of your Association's contact information on the OASA's and Softball Ontario's web site to assist in promoting registration, and the reporting of registration information to Softball Ontario.

Association contact information and program offerings may also be released to potential participants to assist in placing them in finding a local association. I understand that I may withdraw consent to the collection, use or disclosure of my Association's information at any time by contacting the OASA.

Please read this section:
We have tried to simplify the application form so that it is easier to fill out. This means that there will be a spreadsheet emailed with your certificate for you to fill out your statistics. We require you to complete this spreadsheet and email it back to us - we need this information for both Softball Ontario and Softball Canada and we need the team names and number of players for the insurance especially if you have Sport Accident coverage.

Section 1: Contact/Association Information
If you can please be sure to use the same name as is on your certificate, unless you have changed the name of your association or league or if it was wrong. In some centres we have several associations and it helps to find you and to keep our records up to date.
Section 2: Liability Insurance
Liability Insurance is mandatory for play in all OASA tournaments. Most other tournaments will carry their own liability insurance, but that usually assumes that all teams will carry their own liability insurance. Check with your tournament coordinator. Affiliated teams are those who have affiliated with the OASA to play in qualifier, elimination or provincial tournaments run by the OASA, all others are deemed to be non-affiliated.
Section 3: Named Third-Party
Most Municipalities and School Boards require that your certificate name them for you to get your permits. Whoever issues your permit will be able to give you this information about the legal name required. This section MUST be filled out even if you circle NO and sign.
Section 4: Sport Accident Insurance (Optional)
We recommend the Sport Accident Insurance as additional peace of mind. Concussions and dental injuries can have longterm affects and this helps to cover some of the costs. (please see the accompanying page for a summary of coverage). Adult teams are those with ANY player over 18 years of age. A form that will arrive with your certificate or soon after —please fill it out as a spreadsheet and email it back to assist us in data entry.

Statistics form that will arrive with your certificate –please fill it out as a spreadsheet and email back to assist us in data entry.

Garry Waugh
OASA Insurance Coordinator
45 Earlscourt Crescent
Woodstock, ON N4S 5H2
Telephone: 519-537-5835
Fax: 519-537-5835
EMail: insurance.OASA@execulink.com
Web-site:www.oasa.ca