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Each itemized bill MUST show the following: 2026
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- Click ‘Get Form’ to open the Youth Soccer Accident Claim Form in the editor.
- Complete all questions in Section I, including claimant details and accident information. Ensure accuracy for a smooth processing experience.
- In Section III, have the coach or local official who witnessed the accident sign to verify the incident.
- Sign Section VI, which is the Statement of Certification/Authorization to Release Information, confirming that all provided information is accurate.
- Attach any itemized bills and Explanation of Benefits (EOB) from other insurance carriers if available, ensuring they meet the required details outlined in the guidelines.
- Submit your completed claim form to your State Association for verification and authorized state signature.
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