Buy League/Group Insurance

U.S. Amateur Basketball, LLC

If you are NOT purchasing for 100% of your group then contact Chappell Insurance (1-800-447-6797) before proceeding.
All teams in your leage/group must have the same deductible.

Group Name:

Group Website:

Sport:

Email:

State:

You confirm that you have a waiver system in place.

Yes No

You confirm that you have not had a claim over 25K in the past 5 years.

Yes No

	Sport/Age	Coverage Type	Coverage Term	Cost per Team
Team insurance age bracket is determined by oldest child on date of purchase.
Basketball
Coverage Term - Time Of Purchase To 1/1/25 Youth - $2 million General Liability/$100K Accident Medical Adult - $2 million General Liability/$10K Accident Medical
	Basketball - (Ages Youth - 18 & Under)	Liability & $500.00 Deductible Medical	Time Of Purchase To 1/1/25	$92.00
	Basketball - (Ages Adult)	Liability & $500.00 Deductible Medical	Time Of Purchase To 1/1/25	$198.00
Coverage Term - Time Of Purchase To 8/1/24 Youth - $2 million General Liability/$100K Accident Medical Adult - $2 million General Liability/$10K Accident Medical
	Basketball - (Ages Youth - 18 & Under)	Liability & $500.00 Deductible Medical	Time Of Purchase To 8/1/24	$92.00
	Basketball - (Ages Adult)	Liability & $500.00 Deductible Medical	Time Of Purchase To 8/1/24	$198.00

Buy League/Group Insurance

U.S. Amateur Basketball, LLC

Basketball

Coverage Term - Time Of Purchase To 1/1/25

Coverage Term - Time Of Purchase To 8/1/24

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