USDA

Live Lively - Square Dance

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The Worlds Largest Square Dance Organization

The Only National Dancer's Association Organized By Dancers For Dancers And Operated By Dancers

 

USDA Dancers Insurance Program

These Forms Are For Use By USDA Affiliate Insurance Chairmen

Please Use These Forms
You May Fill In On Your Computer, Or Print & Fill In With A Pen

The Insurance Enrollment Form Must Be Mailed With Enrollment Check

 

 
 
 

How to use the USDA Insurance portalAdobe PDF Printable Copy5/5/20


Insurance Program Additional Information SheetAdobe PDF Printable Copy5/29/16


Insurance Program InformationAdobe PDF Printable Copy5/29/16


Federation or Association Club Enrollment FormAdobe PDF Printable Copy10/1/19


Club Roster FormAdobe PDF Printable Copy1/5/15


Club Members Insured Through A Different Club FormAdobe PDF Printable Copy12/29/15


Insurance Enrollment Form (Insurance Chairmen Only)Adobe PDF Printable Copy5/4/20


Additional Dancer Enrollment FormAdobe PDF Printable Copy9/15/15


Inspection of Premises FormAdobe PDF Printable Copy8/8/07


Event Notification and Group Travel FormAdobe PDF Printable Copy9/3/08


Request for CertificateAdobe PDF Printable Copy7/13/09


Club Sponsored Class FormAdobe PDF Printable Copy8/12/07


When, How, & Where to File a ClaimAdobe PDF Printable Copy10/1/19


Club Accident ProceduresAdobe PDF Printable Copy7/20/20


Accident Report FormAdobe PDF Printable Copy7/27/09


Part 1 and 2 InformationAdobe PDF Printable Copy8/12/07


Insurance Program Information TrifoldAdobe PDF Printable Copy9/17/19


Dancers Code of Ethics and Conduct TrifoldAdobe PDF Printable Copy8/30/18


USDA Officers and Committees TrifoldAdobe PDF Printable Copy3/29/20


   
 
 

Or Contact Our:

Insurance Coordinator
Eddie & Elizabeth Sanders
P.O. Box 417
Stephens, Georgia 30667-0417
Phone 706.759.3642
E-Mail: Insurance@usda.org

 

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7/15/21