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: 7/27/2017 at 3:00PM

Declaration Forms Received as : 7/27/2017 at 5:00PM

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
0964  CT  Farmington Valley Branch YMCA  12/31/2017    Check Your faxes  Monday, July 24, 2017 
0976  CT  Cheshire YMCA  1/1/2018    Check Your faxes  Friday, July 28, 2017 
0983  CT  Laurel East Hartford YMCA  12/31/2017    Check Your faxes  Thursday, July 20, 2017 
0989  CT  New Canaan Community YMCA  11/7/2017    Check Your faxes  Thursday, July 27, 2017 
0996  CT  Soundview Family YMCA  5/1/2017  Ins must be updated  Check Your faxes  Monday, July 24, 2017 
1024  CT  Wilton Family YMCA  12/29/2017    Check Your faxes  Thursday, July 27, 2017 
1033  CT  Regional YMCA of Western Connecticut  7/1/2018    Check Your faxes  Tuesday, July 25, 2017 
1049  CT  Darien Community YMCA  12/31/2017    Check Your faxes  Monday, July 24, 2017 
1089  DE  Brandywine DE YMCA  8/1/2017  Ins must be updated  Check Your faxes  Wednesday, July 26, 2017 
1105  DE  Western Branch YMCA  8/1/2017  Ins must be updated  Check Your faxes  Thursday, July 27, 2017 
1193  FL  Suncoast YMCA  5/1/2018    Check Your faxes  Monday, July 24, 2017 
1245  FL  South Florida YMCA  3/31/2018       
1285  FL  Central Florida Metro YMCA  6/1/2018       
1335  FL  South County Family YMCA - FL  4/13/2017  Ins must be updated  Check Your faxes  Friday, July 28, 2017 
1575  IL  Champaign County YMCA  3/1/2018       
1627  IL  Leaning Tower YMCA  10/1/2017    Check Your faxes  Tuesday, July 25, 2017 
1743  IL  Kishwaukee Family YMCA  9/5/2017    Check Your faxes  Wednesday, July 26, 2017 
1755  IL  Edwardsville YMCA  2/1/2018       
1767  IL  Fayette County Family YMCA  3/19/2018    Check Your faxes  Thursday, July 27, 2017 
2099  IN  Michiana YMCA  7/1/2017  Ins must be updated  Check Your faxes  Wednesday, July 26, 2017 
2314  KS  Andover YMCA  1/1/2018    Check Your faxes  Monday, July 24, 2017 
2337  KY  Ashland Area YMCA  7/15/2017  Ins must be updated  Check Your faxes  Thursday, July 27, 2017 
2353  KY  RC Durr Family YMCA  1/1/2018    Check Your faxes  Wednesday, July 26, 2017 
2517  ME  Down East Family YMCA  1/1/2018    Check Your faxes  Tuesday, July 25, 2017 
2537  ME  Bath Area Family YMCA  10/1/2017    Check Your faxes  Monday, July 24, 2017 
2581  MD  YMCA in Central Maryland  11/1/2017       
2583  MD  SPY Greater Annapolis YMCA    Ins must be updated  Check Your faxes  Friday, July 28, 2017 
2619  MD  Hagerstown Maryland YMCA  6/13/2018    Check Your faxes  Wednesday, July 19, 2017 
2623  MD  Frederick County YMCA  7/1/2018    Check Your faxes  Tuesday, July 25, 2017 
2637  MA  Andover North Andover YMCA  4/1/2018       
2849  MA  South Shore MA YMCA  1/1/2018    Check Your faxes  Wednesday, July 26, 2017 
2861  MA  North Shore Sterling MA YMCA  12/29/2017    Check Your faxes  Thursday, July 27, 2017 
2901  MA  Greater Westfield YMCA  9/16/2017    Check Your faxes  Monday, July 24, 2017 
3017  MI  Greater Flint YMCA  5/10/2018    Check Your faxes  Friday, July 28, 2017 
3031  MI  Rapid Area YMCA  8/1/2017  Ins must be updated  Check Your faxes  Friday, July 28, 2017 
3589  NH  Greater Nashua YMCA  9/1/2017    Check Your faxes  Thursday, July 27, 2017 
3685  NJ  Fanwood Scotch Plains YMCA  4/15/2017  Ins must be updated  Check Your faxes  Monday, July 24, 2017 
3729  NJ  Wyckoff Family YMCA Inc  4/1/2018    Check Your faxes  Tuesday, July 25, 2017 
3753  NJ  Lakeland Hills Family YMCA  3/31/2018    Check Your faxes  Wednesday, July 26, 2017 
3765  NJ  Hamilton Area NJ YMCA  5/15/2018    Check Your faxes  Wednesday, July 26, 2017 
3786  NJ  Metuchen Edison YMCA  3/31/2018    Check Your faxes  Thursday, July 27, 2017 
3791  NJ  Montclair YMCA  3/31/2018    Check Your faxes  Monday, July 24, 2017 
3832  NJ  Sussex County Branch YMCA  6/1/2018       
3863  NJ  Ocean County YMCA  10/1/2016  Ins must be updated  Check Your faxes  Friday, July 21, 2017 
3883  NJ  Red Bank Branch  8/1/2018    Check Your faxes  Wednesday, July 26, 2017 
3885  NJ  Ridgewood NJ YMCA  8/1/2017  Ins must be updated  Check Your faxes  Tuesday, July 25, 2017 
3915  NJ  Somerset Hills YMCA  4/1/2018    Check Your faxes  Friday, July 28, 2017 
3919  NJ  Somerset Valley YMCA  4/1/2018    Check Your faxes  Wednesday, July 26, 2017 
3951  NJ  Westfield YMCA  12/31/2017       
4425  NY  Duanesburg YMCA  4/1/2018    Check Your faxes  Friday, July 21, 2017 
4480  NC  Western North Carolina YMCA  10/1/2017    Check Your faxes  Wednesday, July 26, 2017 
4500  NC  Alamance County Community YMCA  4/1/2018       
4546  NC  Goldsboro Family YMCA  1/1/2018    Check Your faxes  Wednesday, July 19, 2017 
4549  NC  Greensboro YMCA  8/1/2018    Check Your faxes  Thursday, July 27, 2017 
4579  NC  Hickory Foundation YMCA  1/1/2018    Check Your faxes  Monday, July 24, 2017 
4614  NC  Rocky Mount Family YMCA  5/1/2018    Check Your faxes  Monday, July 24, 2017 
4795  OH  Auglaize Mercer Counties YMCA  4/1/2019    Check Your faxes  Wednesday, July 26, 2017 
4805  OH  Blue Ash YMCA  1/1/2018    Check Your faxes  Wednesday, July 26, 2017 
4817  OH  ME Lyons Anderson YMCA  1/1/2018    Check Your faxes  Wednesday, July 26, 2017 
4827  OH  Powel Crosley Jr YMCA  1/1/2018    Check Your faxes  Friday, July 28, 2017 
4915  OH  Ridgewood Branch OH YMCA  12/31/2017    Check Your faxes  Tuesday, July 25, 2017 
4974  OH  Liberty Township Powell YMCA  6/30/2018    Check Your faxes  Tuesday, July 25, 2017 
4991  OH  Jerry L Garver YMCA  6/30/2018    Check Your faxes  Friday, July 28, 2017 
5018  OH  Coffman Family YMCA  8/1/2017  Ins must be updated  Check Your faxes  Thursday, July 27, 2017 
5023  OH  South Family YMCA  8/1/2017  Ins must be updated  Check Your faxes  Thursday, July 27, 2017 
5025  OH  Countryside Ralph Stolle YMCA  10/11/2017       
5155  OH  Miami County Ohio YMCA  3/1/2018       
5178  OH  Springfield Family YMCA  8/30/2017    Check Your faxes  Tuesday, July 25, 2017 
5219  OH  Eastern Community Branch YMCA  9/15/2016  Ins must be updated  Check Your faxes  Tuesday, July 25, 2017 
5254  OH  Lakota Family YMCA  9/30/2018    Check Your faxes  Wednesday, July 26, 2017 
5517  PA  Bradford Family YMCA  2/1/2018    Check Your faxes  Wednesday, July 26, 2017 
5528  PA  Butler YMCA  11/1/2017    Check Your faxes  Wednesday, July 26, 2017 
5545  PA  Carlisle Family YMCA  7/1/2018    Check Your faxes  Monday, July 24, 2017 
5549  PA  Chambersburg Memorial YMCA  10/20/2017    Check Your faxes  Thursday, July 27, 2017 
5566  PA  Jennersville YMCA  9/1/2017    Check Your faxes  Tuesday, July 25, 2017 
5603  PA  Grove City YMCA-PA  8/1/2017  Ins must be updated  Check Your faxes  Monday, July 24, 2017 
5695  PA  Tri Hampton Family YMCA  7/1/2016  Ins must be updated  Check Your faxes  Tuesday, July 25, 2017 
5781  PA  Ridley Area YMCA  1/1/2018    Check Your faxes  Wednesday, July 26, 2017 
5812  PA  Phoenixville Branch YMCA  1/1/2018       
5896  PA  Upper Perkiomen Valley YMCA  1/1/2018    Check Your faxes  Thursday, July 27, 2017 
5907  PA  Reading and Berks County YMCA  1/1/2018    Check Your faxes  Wednesday, July 26, 2017 
5908  PA  Boyertown Area YMCA  1/1/2018    Check Your faxes  Monday, July 24, 2017 
5944  PA  Sunbury Branch YMCA  4/30/2017  Ins must be updated  Check Your faxes  Friday, July 21, 2017 
5966  PA  Lionville Community YMCA  9/1/2017    Check Your faxes  Monday, July 24, 2017 
5967  PA  Upper Main Line YMCA  9/1/2017    Check Your faxes  Friday, July 28, 2017 
5985  PA  Kennett Area YMCA  9/1/2017    Check Your faxes  Monday, July 17, 2017 
5986  PA  West Chester Area YMCA  9/1/2017    Check Your faxes  Monday, July 24, 2017 
5995  PA  York And York County YMCA  1/15/2018    Check Your faxes  Wednesday, July 26, 2017 
6030  RI  Newport County YMCA  8/1/2017  Ins must be updated  Check Your faxes  Wednesday, July 26, 2017 
6046  RI  Bayside Branch YMCA  8/31/2017    Check Your faxes  Friday, July 21, 2017 
6082  SC  Anderson Area YMCA  1/15/2018    Check Your faxes  Tuesday, July 25, 2017 
6088  SC  Newberry County Family YMCA  12/31/2017    Check Your faxes  Monday, July 24, 2017 
6099  SC  Summerville Family YMCA    Ins must be updated  Check Your faxes  Wednesday, July 26, 2017 
6109  SC  Columbia Northwest Family YMCA  10/1/2017    Check Your faxes  Friday, July 28, 2017 
6132  SC  Greater Spartanburg YMCA  8/1/2017  Ins must be updated  Check Your faxes  Monday, July 24, 2017 
6152  SC  Rock Hill Aquatics Center  7/15/2017  Ins must be updated  Check Your faxes  Wednesday, July 26, 2017 
6682  VA  Piedmont Family YMCA  12/31/2017    Check Your faxes  Thursday, July 27, 2017 
6721  VA  Lynchburg YMCA  7/10/2018       
6731  VA  Martinsville and Henry Co YMCA  12/31/2017    Check Your faxes  Monday, July 24, 2017 
6798  VA  Salem Family Branch  9/1/2017       
6807  VA  Waynesboro Family YMCA  1/26/2018    Check Your faxes  Tuesday, July 25, 2017 
6947  WA  Haselwood Family YMCA  12/31/2017    Check Your faxes  Friday, July 21, 2017 
7029  WV  Wheeling YMCA  9/15/2017    Check Your faxes  Thursday, July 27, 2017 
7066  WI  Door County YMCA  1/1/2018    Check Your faxes  Thursday, July 27, 2017 
7155  WI  Oshkosh Community YMCA  1/1/2018    Check Your faxes  Friday, July 28, 2017