COI Request Form

Chapter Request for
Event Certificate of Insurance

Official activities of AHS Chapters are covered by AHS's liability policy. This form is to be used to request a formal certificate of insurance from our underwriters when needed by an event venue such as a church, community hall or college facility. This is not needed for chapter meetings and other general chapter activities.

Host AHS chapter

Event name

Date of event

YYYY

Start time (include any setup time)

End time (including clean up/move out)

Estimated attendance (including both performers and any audience)

Venue name and address

Venue contact name

Venue contact email address

Venue contact telephone number

Requested by

Requestor email address

Any additional comments

Optionally upload any venue documents that may be helpful to the insurance agent.

Delete all uploads

Choose files or drag here

Chapter Request forEvent Certificate of Insurance

Chapter Request for
Event Certificate of Insurance