CAMP LIABILITY INSURANCE PROGRAM

PARTICIPANT ACCIDENT & LIABILITY INSURANCE COVERAGE

Camp Information

Are you a current Ryzer client?

Yes, we are an active client

No, we are not affiliated with Ryzer

Full Legal Name of Organization

Note: This is the name that will appear on your Certificate of Insurance. If your company is a Sole Proprietorship, then this will be your personal name of DBA.

Contact Name

First Name

Last Name

Phone

(###)

###

####

Email

Fax Number

(###)

###

####

Mailing Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country