Certificate of Insurance Request Form

When organizations rent, lease or reserve fields or facilities, the owner (e.g. town or facility owner) often asks for proof of insurance.  This form is used to request a Certificate of Insurance.  You must submit form(s) with name of location and address.   Only the President or the Registrar of an affiliated youth soccer organization can request a Certificate of Insurance from our office.

If you would like a General Certificate of Insurance that shows your organization is insured, please write "general" in the "Additional Insured to be Shown on Certificate" field.

The Certificate of Insurance will typically take 2-3 days to process, so please plan ahead!  The certificate CANNOT BE ISSUED if your organization is not properly affiliated with Massachusetts Youth Soccer for the current season.  

If you need more than one certificate, please DO NOT use your "back" button to return to the form.  Please return to the form through from the Certificate of Insurance web site page, not the form page, and be sure to refresh your browser when you open the form.  If you use your "back" button and do not refresh the form, your subsequent requests will not be submitted.

Please note:  This certificate is for games and practices involving the affiliated organization ONLY. Insurance coverage does NOT extend to any events not sanctioned or acknowledged as approved for coverage by Massachusetts Youth Soccer.  We will not provide this certificate unless your organization is affiliated with Massachusetts Youth Soccer.

Your submission of this request acknowledges that your organization is in full compliance with all Massachusetts Youth Soccer COVID-19 Return to Soccer Activities Guidelines.  In addition you acknowledge your organization is in full compliance with any COVID-19 regulations as provided by the CDC, Commonwealth of Massachusetts Department of Public Health and the Health Department of the local government (town, city, county, municipality).

If you have any questions you can reach Rachel Woo at RWoo@mayouthsoccer.org or by phone at 978/466-8812 x236.

The Affiliated Organization is the soccer club or team which is affiliated with Massachusetts Youth Soccer (e.g. Adams Youth Soccer)
The Additional Insured to be shown on the certificate, that is, the name of the facility requesting the certificate.
We cannot process a Certificate for an Additional Insured without a mailing/street address!