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: 7/26/2019 at 5:00PM

Declaration Forms Received as :
7/28/2019 at 7:00AM

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 Shorte 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 (the preferred method) with scan images of certificates will be accepted. Email may be sent to Erin Reuland.
Although email is preferred, Certificates of Insurance may also be faxed to 312-977-0013, 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
0153  AK  Anchorage Alaska YMCA  10/1/2017  Ins must be updated  Check Your faxes  Thursday, July 25, 2019 
0951  CT  Greenwich YMCA  1/1/2020    Check Your faxes  Saturday, July 27, 2019 
0964  CT  Farmington Valley Branch YMCA  1/1/2020    Check Your faxes  Sunday, July 28, 2019 
0976  CT  Cheshire YMCA  1/1/2020       
0983  CT  Laurel East Hartford YMCA  1/1/2020    Check Your faxes  Thursday, July 11, 2019 
0989  CT  New Canaan Community YMCA  11/7/2019       
0996  CT  Soundview Family YMCA  5/1/2020    Check Your faxes  Monday, July 22, 2019 
1024  CT  Wilton Family YMCA  12/29/2019    Check Your faxes  Tuesday, July 23, 2019 
1033  CT  Regional YMCA of Western Connecticut  7/1/2020       
1061  CT  Wallingford Family YMCA  7/1/2020    Check Your faxes  Thursday, July 18, 2019 
1065  CT  Greater Waterbury YMCA  10/1/2019    Check Your faxes  Friday, July 26, 2019 
1087  DE  Dover YMCA  8/1/2020    Check Your faxes  Saturday, July 27, 2019 
1089  DE  Brandywine DE YMCA  8/1/2020    Check Your faxes  Tuesday, July 23, 2019 
1105  DE  Western Branch YMCA  8/1/2020    Check Your faxes  Saturday, July 27, 2019 
1126  VA  Fairfax County YMCA in Reston  10/1/2019    Check Your faxes  Wednesday, July 24, 2019 
1193  FL  Suncoast YMCA  5/1/2020    Check Your faxes  Monday, July 22, 2019 
1245  FL  South Florida YMCA  3/31/2020       
1575  IL  Champaign County YMCA  3/1/2020       
1580  IL  Sage YMCA  10/1/2019    Check Your faxes  Monday, July 22, 2019 
1743  IL  Kishwaukee Family YMCA  9/5/2019    Check Your faxes  Saturday, July 27, 2019 
1785  IL  Joliet YMCA  7/1/2019  Ins must be updated     
1843  IL  BR Ryall NW Dupage YMCA  1/20/2020    Check Your faxes  Tuesday, July 23, 2019 
2353  KY  RC Durr Family YMCA  1/1/2020    Check Your faxes  Tuesday, July 23, 2019 
2517  ME  Down East Family YMCA  1/1/2020    Check Your faxes  Tuesday, July 23, 2019 
2521  ME  Kennebec Valley YMCA  1/1/2020    Check Your faxes  Tuesday, July 23, 2019 
2529  ME  Bangor YMCA  12/31/2018  Ins must be updated  Check Your faxes  Monday, July 29, 2019 
2537  ME  Bath Area Family YMCA  11/13/2019    Check Your faxes  Tuesday, July 23, 2019 
2581  MD  YMCA in Central Maryland  11/1/2019       
2583  MD  SPY Greater Annapolis YMCA    Ins must be updated  Check Your faxes  Saturday, July 27, 2019 
2605  MD  Cumberland MD YMCA  7/11/2020    Check Your faxes  Wednesday, July 24, 2019 
2615  MD  Cecil County YMCA  12/31/2019    Check Your faxes  Friday, July 26, 2019 
2619  MD  Hagerstown Maryland YMCA  1/1/2021    Check Your faxes  Tuesday, July 16, 2019 
2623  MD  Frederick County YMCA  7/1/2020       
2626  MD  Richard A Henson Family YMCA  12/31/2019    Check Your faxes  Thursday, July 25, 2019 
2637  MA  Andover North Andover YMCA  4/1/2020    Check Your faxes  Sunday, July 21, 2019 
2769  MA  Greater Holyoke YMCA  10/15/2019    Check Your faxes  Friday, July 26, 2019 
2849  MA  South Shore MA YMCA  1/1/2020    Check Your faxes  Saturday, July 27, 2019 
2853  MA  Burbank Branch YMCA  9/30/2019    Check Your faxes  Saturday, July 27, 2019 
3031  MI  Rapid Area YMCA  8/1/2019  Ins must be updated  Check Your faxes  Monday, July 29, 2019 
3461  MT  Greater Missoula Family YMCA  1/1/2020       
3685  NJ  Fanwood Scotch Plains YMCA  4/15/2020    Check Your faxes  Tuesday, July 23, 2019 
3725  NJ  Meadowlands Area YMCA  7/1/2020    Check Your faxes  Saturday, July 27, 2019 
3729  NJ  Wyckoff Family YMCA Inc  4/1/2020    Check Your faxes  Friday, July 19, 2019 
3753  NJ  Lakeland Hills Family YMCA  1/1/2020    Check Your faxes  Wednesday, July 24, 2019 
3757  NJ  Madison Area YMCA  12/31/2019    Check Your faxes  Monday, July 22, 2019 
3765  NJ  Hamilton Area NJ YMCA  5/15/2020    Check Your faxes  Wednesday, July 24, 2019 
3786  NJ  Metuchen Edison YMCA  3/31/2020    Check Your faxes  Sunday, July 28, 2019 
3791  NJ  Montclair YMCA  3/31/2020    Check Your faxes  Monday, July 22, 2019 
3795  NJ  Randolph YMCA  1/1/2020    Check Your faxes  Tuesday, July 23, 2019 
3827  NJ  Metropolitan YMCA Of The Oranges  6/1/2020    Check Your faxes  Wednesday, July 17, 2019 
3832  NJ  Sussex County Branch YMCA  6/1/2020    Check Your faxes  Thursday, July 11, 2019 
3863  NJ  Ocean County YMCA  10/1/2019    Check Your faxes  Saturday, July 27, 2019 
3883  NJ  Red Bank Branch YMCA  9/1/2019    Check Your faxes  Wednesday, July 24, 2019 
3885  NJ  Ridgewood NJ YMCA  9/4/2019    Check Your faxes  Sunday, July 28, 2019 
3915  NJ  Somerset Hills YMCA  4/1/2020    Check Your faxes  Saturday, July 27, 2019 
3919  NJ  Somerset Valley YMCA  4/1/2020    Check Your faxes  Tuesday, July 23, 2019 
3928  NJ  Summit Branch YMCA  7/1/2020    Check Your faxes  Tuesday, July 23, 2019 
3951  NJ  Westfield YMCA  12/31/2019    Check Your faxes  Saturday, July 27, 2019 
3998  NY  Skaneateles YMCA  3/1/2020       
4181  NY  East Hampton RECenter YMCA  5/15/2020    Check Your faxes  Thursday, July 25, 2019 
4256  NY  Flushing YMCA  4/1/2020    Check Your faxes  Tuesday, July 23, 2019 
4424  NY  Greater Glenville YMCA  4/1/2020       
4470  NC  YMCA of Asheboro NC Inc  3/18/2020    Check Your faxes  Monday, July 22, 2019 
4500  NC  Alamance County Community YMCA  4/1/2020       
4546  NC  Goldsboro Family YMCA  1/1/2020    Check Your faxes  Sunday, July 21, 2019 
4549  NC  Greensboro YMCA  8/1/2020    Check Your faxes  Friday, July 26, 2019 
4622  NC  Wilmington YMCA NC  8/1/2019  Ins must be updated  Check Your faxes  Friday, July 19, 2019 
4626  NC  Northwest North Carolina YMCA  7/1/2020    Check Your faxes  Tuesday, July 23, 2019 
4795  OH  Auglaize Mercer Counties YMCA  4/1/2020       
4805  OH  Blue Ash YMCA  1/1/2020    Check Your faxes  Wednesday, July 24, 2019 
4817  OH  ME Lyons Anderson YMCA  1/1/2020    Check Your faxes  Monday, July 22, 2019 
4827  OH  Powel Crosley Jr YMCA  1/1/2020    Check Your faxes  Saturday, July 27, 2019 
4915  OH  Ridgewood Branch OH YMCA  12/31/2019    Check Your faxes  Tuesday, July 23, 2019 
5018  OH  Coffman Family YMCA  8/1/2019  Ins must be updated  Check Your faxes  Sunday, July 28, 2019 
5023  OH  South Family YMCA  8/1/2019  Ins must be updated  Check Your faxes  Saturday, July 27, 2019 
5065  OH  Great Miami Valley Ohio YMCA  11/1/2019    Check Your faxes  Friday, July 26, 2019 
5083  OH  Lancaster and Fairfield YMCA  9/1/2020    Check Your faxes  Wednesday, July 24, 2019 
5155  OH  Miami County Ohio YMCA  3/1/2021    Check Your faxes  Friday, July 26, 2019 
5178  OH  Springfield Family YMCA  8/30/2020    Check Your faxes  Saturday, July 27, 2019 
5222  OH  Fort Meigs YMCA  9/15/2019    Check Your faxes  Tuesday, July 23, 2019 
5254  OH  Lakota Family YMCA  9/30/2019    Check Your faxes  Thursday, July 25, 2019 
5517  PA  Bradford Family YMCA  2/1/2020    Check Your faxes  Wednesday, July 24, 2019 
5549  PA  Chambersburg Memorial YMCA  10/20/2019    Check Your faxes  Monday, July 22, 2019 
5566  PA  Jennersville YMCA  9/1/2019    Check Your faxes  Wednesday, July 24, 2019 
5617  PA  Greensburg YMCA  7/1/2020    Check Your faxes  Wednesday, July 24, 2019 
5657  PA  Greater Johnstown Community  5/4/2020    Check Your faxes  Wednesday, July 24, 2019 
5695  PA  Tri Hampton Family YMCA  9/1/2019    Check Your faxes  Tuesday, July 23, 2019 
5781  PA  Ridley Area YMCA  1/1/2020    Check Your faxes  Saturday, July 27, 2019 
5812  PA  Phoenixville Branch YMCA  1/1/2020       
5896  PA  Upper Perkiomen Valley YMCA  1/1/2020    Check Your faxes  Wednesday, July 24, 2019 
5907  PA  Reading and Berks County YMCA  1/1/2020    Check Your faxes  Tuesday, July 23, 2019 
5908  PA  Boyertown Area YMCA  1/1/2020    Check Your faxes  Sunday, July 28, 2019 
5938  PA  State College Family YMCA  1/2/2020    Check Your faxes  Monday, July 22, 2019 
5944  PA  Greater Susquehanna Valley YMCA  4/30/2020    Check Your faxes  Wednesday, July 24, 2019 
5966  PA  Lionville Community YMCA  9/1/2019    Check Your faxes  Saturday, July 27, 2019 
5967  PA  Upper Main Line YMCA  9/1/2019    Check Your faxes  Saturday, July 27, 2019 
5985  PA  Kennett Area YMCA  9/1/2019    Check Your faxes  Tuesday, July 23, 2019 
5986  PA  West Chester Area YMCA  9/1/2019    Check Your faxes  Saturday, July 27, 2019 
5995  PA  York And York County YMCA  1/15/2020    Check Your faxes  Wednesday, July 24, 2019 
5997  PA  Hanover Area YMCA  1/1/2020    Check Your faxes  Saturday, July 27, 2019 
6030  RI  Newport County YMCA  8/1/2019  Ins must be updated  Check Your faxes  Thursday, July 18, 2019 
6046  RI  Bayside Branch YMCA  8/31/2019    Check Your faxes  Thursday, July 25, 2019 
6082  SC  Anderson Area YMCA  1/15/2020    Check Your faxes  Saturday, July 27, 2019 
6109  SC  Columbia Northwest Family YMCA  1/1/2020    Check Your faxes  Saturday, July 27, 2019 
6132  SC  Greater Spartanburg YMCA  8/1/2020    Check Your faxes  Tuesday, July 23, 2019 
6682  VA  Piedmont Family YMCA  12/31/2019    Check Your faxes  Tuesday, July 23, 2019 
6721  VA  Lynchburg YMCA  7/10/2020    Check Your faxes  Saturday, July 27, 2019 
6798  VA  Salem Family YMCA  9/1/2019       
6807  VA  Waynesboro Family YMCA  1/26/2018  Ins must be updated     
6989  WV  Tri County YMCA Inc  7/1/2019  Ins must be updated  Check Your faxes  Saturday, July 27, 2019 
7025  WV  Parkersburg YMCA  12/31/2019    Check Your faxes  Saturday, July 20, 2019 
7029  WV  Wheeling YMCA  9/15/2019    Check Your faxes  Friday, July 26, 2019 
7066  WI  Door County YMCA  1/1/2020    Check Your faxes  Wednesday, July 24, 2019 
7073  WI  La Crosse Area Family YMCA  7/1/2020    Check Your faxes  Thursday, July 18, 2019 
7155  WI  Oshkosh Community YMCA  1/1/2020    Check Your faxes  Saturday, July 27, 2019