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the san diego association of car clubs offers 4 million aggregate event insurance to car club members and associate members.

If you are a member of the Council and have an event coming up that you would like to take part in the benefit of car related 4 million aggregate event insurance | Please fill out the form.

You must completely fill out the form and submit it to receive insurance. NOTE: if you are requesting there to be additional insured, please contact the agency or organization requesting that to get the EXACT language they require and do NOT submit an insure request until you have that information complete. If you have submitted your event information and have questions please feel free to email the contact us!

Insurance Application

Please submit your application at least four (4) weeks before your show or event.

Must allow at minimum 4 weeks processing time after submission. Any changes must be submitted as new.

For more information please e-mail Paul at pephog57@gmail.com

Name of Requesting Car Club Chapter

Club Contact Person for Event

The person to be contacted for questions.

First Name

Last Name

Email

Email address of event contact

Phone #

Phone # of event contact

(###)

###

####

Approx. Number of "Members" of Club in Attendance

Not number of people attending event

Type of Event

Example: Parade of Car Show

Dates of Event(s)

(mm/dd/yyyy) Please list the date(s) of events. You can list multiple dates here if event is ongoing or is more than a single day.

Owner of Premises Name

Name of owner of location of event.

First Name

Last Name

Phone Number

Owner of Premises Phone Number

(###)

###

####

Address

Owner of Premises Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Location of Event

Full physical address including zip code

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Premise Phone Number

Phone Number of event location

(###)

###

####

The additionally insured is as follows:

Make sure the name and address is correct per the agency or property owner requirements BEFORE you submit this form.”