YMCA National Swimming and Diving YMCA National Swimming and Diving YMCA NATIONAL CHAMPIONSHIP EVENTS

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Team Insurance List and Faxes Received

Insurances as: 7/27/2018 at 8:00AM

Declaration Forms Received as :
7/27/2018 at 6:00PM

Insurance Certificate expiration dates have been updated
Insurances should be faxed to the YMCA Of USA - 312-977-1134

Faxes/emails that have been received will also be posted as we get closer to the entry deadline.  You will be able to view your form to ensure the information has been correctly received

Only one form needs to be faxed/emailed this year
  1) CERTIFICATION, ELIGIBILITY & RELEASE DECLARATION
 

Sample Certificate

Each team that participates in the meet must have a current and correct Certificate of Liability Insurance on file with the YMCA of the USA. Once this form has been submitted to the YMCA of the USA, it should serve to cover all YMCA of the USA sponsored events through the expiration date indicated on the certificate. In other words, a valid certificate that was filed prior to the Short Course Championship that has a long enough expiration date may cover the Masters Championship and the Long Course Championship as well. Exceptions are generally noted in the comments column.

Emails of certificates will be accepted FROM THE INSURANCE BROKER ONLY. Emails may be sent to Robin Lee .
Certificates of Insurance may be faxed to 312-977-1134, HOWEVER, THE ORIGINAL MUST STILL BE SENT to YMCA of the USA, Attn: Insurance Manager, 101 North Wacker Dr., Chicago IL 60606.

Please note: If the insurance column does not have a date,  YMCA of the USA has not yet received a valid insurance certificate. A valid insurance certificate must be received by the YMCA of the USA before the team may compete in a YMCA National meet.


Assoc State Assoc_Name Certificate_Expiration Comments Fax_Received Date_Fax_Received
0951  CT  Greenwich YMCA  1/1/2019    Check Your faxes  Tuesday, July 17, 2018 
0964  CT  Farmington Valley Branch YMCA  12/31/2018    Check Your faxes  Friday, July 27, 2018 
0976  CT  Cheshire YMCA  1/1/2019    Check Your faxes  Wednesday, July 25, 2018 
0983  CT  Laurel East Hartford YMCA  12/31/2018    Check Your faxes  Friday, June 29, 2018 
0989  CT  New Canaan Community YMCA  11/7/2018       
0996  CT  Soundview Family YMCA  5/1/2019       
1024  CT  Wilton Family YMCA  12/29/2018    Check Your faxes  Wednesday, July 18, 2018 
1033  CT  Regional YMCA of Western Connecticut  7/1/2019    Check Your faxes  Tuesday, July 24, 2018 
1057  CT  Torrington Area Branch YMCA  12/31/2017  Ins must be updated     
1087  DE  Dover YMCA  8/1/2018  Ins must be updated  Check Your faxes  Friday, July 27, 2018 
1089  DE  Brandywine DE YMCA  8/1/2018  Ins must be updated  Check Your faxes  Tuesday, July 24, 2018 
1105  DE  Western Branch YMCA  8/1/2018  Ins must be updated  Check Your faxes  Wednesday, July 25, 2018 
1193  FL  Suncoast YMCA  5/1/2019    Check Your faxes  Monday, July 23, 2018 
1245  FL  South Florida YMCA  3/31/2019    Check Your faxes  Friday, July 27, 2018 
1580  IL  Sage YMCA  10/1/2018    Check Your faxes  Monday, July 23, 2018 
1743  IL  Kishwaukee Family YMCA  9/5/2018    Check Your faxes  Wednesday, July 25, 2018 
1785  IL  Joliet YMCA  7/1/2019       
2099  IN  Michiana YMCA  7/1/2019    Check Your faxes  Thursday, July 26, 2018 
2353  KY  RC Durr Family YMCA  1/1/2019    Check Your faxes  Wednesday, July 25, 2018 
2517  ME  Down East Family YMCA  1/1/2019    Check Your faxes  Tuesday, July 24, 2018 
2529  ME  Bangor YMCA  12/31/2018       
2533  ME  Mount Desert Island YMCA  1/1/2019    Check Your faxes  Thursday, July 26, 2018 
2537  ME  Bath Area Family YMCA  10/1/2018    Check Your faxes  Monday, July 16, 2018 
2581  MD  YMCA in Central Maryland  11/1/2018       
2583  MD  SPY Greater Annapolis YMCA    Ins must be updated  Check Your faxes  Friday, July 27, 2018 
2605  MD  Cumberland MD YMCA  7/11/2019    Check Your faxes  Saturday, July 28, 2018 
2619  MD  Hagerstown Maryland YMCA  6/13/2019    Check Your faxes  Thursday, July 12, 2018 
2623  MD  Frederick County YMCA  7/1/2019       
2626  MD  Richard A Henson Family YMCA  12/31/2018    Check Your faxes  Tuesday, July 24, 2018 
2637  MA  Andover North Andover YMCA  4/1/2019    Check Your faxes  Tuesday, July 24, 2018 
2849  MA  South Shore MA YMCA  1/1/2019       
3031  MI  Rapid Area YMCA  8/1/2018  Ins must be updated     
3685  NJ  Fanwood Scotch Plains YMCA  4/15/2019    Check Your faxes  Monday, July 23, 2018 
3725  NJ  Meadowlands Area YMCA    Ins must be updated  Check Your faxes  Friday, July 20, 2018 
3729  NJ  Wyckoff Family YMCA Inc  4/1/2019    Check Your faxes  Wednesday, July 25, 2018 
3753  NJ  Lakeland Hills Family YMCA  3/31/2019    Check Your faxes  Tuesday, July 24, 2018 
3757  NJ  Madison Area YMCA  12/31/2018    Check Your faxes  Tuesday, July 24, 2018 
3765  NJ  Hamilton Area NJ YMCA  5/15/2019       
3779  NJ  Princeton Family YMCA  12/31/2003  Ins must be updated  Check Your faxes  Sunday, July 29, 2018 
3786  NJ  Metuchen Edison YMCA  3/31/2019    Check Your faxes  Friday, July 27, 2018 
3791  NJ  Montclair YMCA  3/31/2019    Check Your faxes  Monday, July 23, 2018 
3795  NJ  Randolph YMCA  1/1/2019    Check Your faxes  Wednesday, July 25, 2018 
3827  NJ  Metropolitan YMCA Of The Oranges  6/1/2019    Check Your faxes  Thursday, July 12, 2018 
3832  NJ  Sussex County Branch YMCA  6/1/2019       
3863  NJ  Ocean County YMCA  10/1/2018    Check Your faxes  Wednesday, July 18, 2018 
3883  NJ  Red Bank Branch YMCA  8/1/2019    Check Your faxes  Wednesday, July 18, 2018 
3885  NJ  Ridgewood NJ YMCA  8/1/2018  Ins must be updated  Check Your faxes  Wednesday, July 25, 2018 
3915  NJ  Somerset Hills YMCA  4/1/2019    Check Your faxes  Friday, July 27, 2018 
3919  NJ  Somerset Valley YMCA  4/1/2019    Check Your faxes  Wednesday, July 25, 2018 
3928  NJ  Summit Branch YMCA  7/1/2019    Check Your faxes  Wednesday, July 25, 2018 
3951  NJ  Westfield YMCA  12/31/2018    Check Your faxes  Tuesday, July 24, 2018 
3998  NY  Skaneateles YMCA  3/1/2019       
4115  NY  Glens Falls YMCA  8/31/2018    Check Your faxes  Wednesday, July 25, 2018 
4256  NY  Flushing YMCA  4/1/2019    Check Your faxes  Tuesday, July 24, 2018 
4425  NY  Duanesburg YMCA  4/1/2019       
4480  NC  Western North Carolina YMCA  10/1/2018    Check Your faxes  Thursday, July 26, 2018 
4546  NC  Goldsboro Family YMCA  11/1/2018    Check Your faxes  Monday, July 23, 2018 
4549  NC  Greensboro YMCA  8/1/2019    Check Your faxes  Friday, July 27, 2018 
4579  NC  Hickory Foundation YMCA  1/1/2019    Check Your faxes  Tuesday, July 24, 2018 
4614  NC  Rocky Mount Family YMCA  5/1/2019    Check Your faxes  Wednesday, July 18, 2018 
4622  NC  Wilmington YMCA NC  8/1/2018  Ins must be updated  Check Your faxes  Wednesday, July 25, 2018 
4626  NC  Northwest North Carolina YMCA  7/1/2019    Check Your faxes  Friday, July 27, 2018 
4795  OH  Auglaize Mercer Counties YMCA  4/1/2019    Check Your faxes  Wednesday, July 25, 2018 
4805  OH  Blue Ash YMCA  1/1/2019    Check Your faxes  Tuesday, July 24, 2018 
4817  OH  ME Lyons Anderson YMCA  1/1/2019    Check Your faxes  Wednesday, July 25, 2018 
4827  OH  Powel Crosley Jr YMCA  1/1/2019    Check Your faxes  Thursday, July 26, 2018 
4891  OH  Geauga Branch YMCA  12/31/2018    Check Your faxes  Friday, July 27, 2018 
4915  OH  Ridgewood Branch OH YMCA  12/31/2018    Check Your faxes  Sunday, July 22, 2018 
4974  OH  Liberty Township Powell YMCA  6/30/2019    Check Your faxes  Tuesday, July 24, 2018 
4991  OH  Jerry L Garver YMCA  6/30/2019    Check Your faxes  Friday, July 27, 2018 
5018  OH  Coffman Family YMCA  8/1/2018  Ins must be updated  Check Your faxes  Friday, July 27, 2018 
5023  OH  South Family YMCA  8/1/2018  Ins must be updated  Check Your faxes  Friday, July 27, 2018 
5025  OH  Countryside Ralph Stolle YMCA  10/11/2018    Check Your faxes  Monday, July 23, 2018 
5083  OH  Lancaster and Fairfield YMCA  9/1/2020    Check Your faxes  Wednesday, July 25, 2018 
5155  OH  Miami County Ohio YMCA  3/1/2021    Check Your faxes  Friday, July 27, 2018 
5178  OH  Springfield Family YMCA  8/30/2020    Check Your faxes  Wednesday, July 25, 2018 
5222  OH  Fort Meigs YMCA  9/15/2018    Check Your faxes  Tuesday, July 24, 2018 
5254  OH  Lakota Family YMCA  9/30/2018    Check Your faxes  Wednesday, July 25, 2018 
5545  PA  Carlisle Family YMCA  7/1/2019    Check Your faxes  Thursday, July 19, 2018 
5549  PA  Chambersburg Memorial YMCA  10/20/2018    Check Your faxes  Thursday, July 19, 2018 
5566  PA  Jennersville YMCA  9/1/2018    Check Your faxes  Friday, July 27, 2018 
5602  PA  Franklin YMCA  8/1/2019    Check Your faxes  Wednesday, July 18, 2018 
5603  PA  Grove City YMCA-PA  8/1/2019    Check Your faxes  Monday, July 23, 2018 
5637  PA  West Shore YMCA  8/1/2018  Ins must be updated     
5673  PA  Lebanon Valley Family YMCA  1/1/2019    Check Your faxes  Tuesday, July 24, 2018 
5781  PA  Ridley Area YMCA  1/1/2019       
5812  PA  Phoenixville Branch YMCA  1/1/2019    Check Your faxes  Thursday, July 26, 2018 
5839  PA  Sampson Family YMCA  1/1/2019    Check Your faxes  Monday, July 23, 2018 
5896  PA  Upper Perkiomen Valley YMCA  1/1/2019    Check Your faxes  Thursday, July 26, 2018 
5907  PA  Reading and Berks County YMCA  1/1/2019    Check Your faxes  Monday, July 23, 2018 
5908  PA  Boyertown Area YMCA  1/1/2019    Check Your faxes  Monday, July 23, 2018 
5928  PA  Schuylkill YMCA  9/1/2018    Check Your faxes  Monday, July 23, 2018 
5938  PA  State College Family YMCA  1/2/2019    Check Your faxes  Friday, July 27, 2018 
5944  PA  Greater Susquehanna Valley YMCA  4/30/2019    Check Your faxes  Tuesday, July 24, 2018 
5961  PA  Uniontown Area YMCA  5/25/2019    Check Your faxes  Friday, July 27, 2018 
5966  PA  Lionville Community YMCA  9/1/2018    Check Your faxes  Friday, July 27, 2018 
5967  PA  Upper Main Line YMCA  9/1/2018    Check Your faxes  Monday, July 23, 2018 
5985  PA  Kennett Area YMCA  9/1/2018    Check Your faxes  Monday, July 23, 2018 
5986  PA  West Chester Area YMCA  9/1/2018    Check Your faxes  Wednesday, July 25, 2018 
5995  PA  York And York County YMCA  1/15/2019    Check Your faxes  Tuesday, July 24, 2018 
5997  PA  Hanover Area YMCA  1/1/2019    Check Your faxes  Sunday, July 29, 2018 
6030  RI  Newport County YMCA  8/1/2018  Ins must be updated     
6046  RI  Bayside Branch YMCA  8/31/2018    Check Your faxes  Friday, July 27, 2018 
6109  SC  Columbia Northwest Family YMCA  1/1/2019    Check Your faxes  Sunday, July 29, 2018 
6132  SC  Greater Spartanburg YMCA  8/1/2018  Ins must be updated  Check Your faxes  Sunday, July 29, 2018 
6152  SC  Rock Hill Aquatics Center YMCA  7/15/2019    Check Your faxes  Tuesday, July 24, 2018 
6682  VA  Piedmont Family YMCA  12/31/2018    Check Your faxes  Tuesday, July 24, 2018 
6807  VA  Waynesboro Family YMCA  1/26/2018  Ins must be updated  Check Your faxes  Wednesday, July 25, 2018 
6989  WV  Tri County YMCA Inc  7/1/2019    Check Your faxes  Wednesday, July 25, 2018 
7007  WV  Harrison Area YMCA  8/1/2018  Ins must be updated     
7029  WV  Wheeling YMCA  9/15/2018    Check Your faxes  Tuesday, July 24, 2018 
7061  WI  Green Bay YMCA Metro  1/1/2019    Check Your faxes  Tuesday, July 24, 2018 
7066  WI  Door County YMCA  1/1/2019    Check Your faxes  Wednesday, July 25, 2018 
7155  WI  Oshkosh Community YMCA  1/1/2019    Check Your faxes  Wednesday, July 25, 2018