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CTR Insurance Request

SEDRA requires ride insurance and offers a SEDRA INSURANCE PROGRAM through The Equestrian Group at a cost of $100, any additional insured will be $27 each.

If your ride is insured through another means, proof of insurance is required.

The SEDRA INSURANCE PROGRAM on-line form must be completed and payment received by Pay Pal. If you do not have an Pay Pal account we can send you an invoice. Or you can mail in your check for $100.00 plus any additional AI fees to Caren Stauffer, SEDRA TR, 181 Riverwoods Dr., Chuluota, FL 32766.

Please be advised the insurance company wishes to communicate with one contact, so please forward any questions to the above address. Gotarace2@aol.com or 407-365-5601

SEDRA CTR Insurance Request

Name of Event*
Location (Physical Address)*
Event dates*
Be sure to include extra day or two for set up/take down dates. Dates of your event can be changed at any time up to 10 days prior to your event start date.
Ride/Event Manager*
First Last
Ride/Event Managers Email Address*
Ride/Event Managers Address*
Street Address City State ZIP Code
Certificate of Insurance (COI)*
Price: $100.00 Quantity:
Certificate of Insurance-Names and Physical Addresses of Event (No PO Box)*
Person(s) requiring Certificate of Insurance
Additional Insured (AI)
Price: $27.00 Quantity:
Additional Insured - Names and Physical Addresses (No PO Box)*
Person(s) requiring AI's, Please list Property owner or property management?
Total
$0.00
Day Member Fees
While using this insurance you will need to collect from non-member participants, 1$ per IDR and 15$ per rider/driver. You will be invoiced after the event. Please leave any comments, additional information that you may want to share.
Comments
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