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USDA Dancers Insurance Program

These Forms Are For Use By USDA Affiliate Insurance Chairmen

Please Use These Forms If You Are Not Using The Portal
You May Fill In On Your Computer, Or Print & Fill In With A Pen

The Insurance Enrollment Form Must Be Mailed With Enrollment Check

Compare MS Word & PDF Copies.  Word Copies May Not Be Latest Version

 

  
 
 
How to use the USDA Insurance portalAdobe PDF Printable CopyMS Word Copy11/1/24

Insurance Program Additional Information SheetAdobe PDF Printable CopyMS Word Copy12/12/25

Federation or Association Club Enrollment FormAdobe PDF Printable CopyMS Word Copy4/25/22

Club Roster FormAdobe PDF Printable CopyMS Word Copy6/8/23

Club Members Insured Through A Different Club FormAdobe PDF Printable CopyMS Word Copy6/8/23

Summary Form for Association/Federation Insurance Chairmen OnlyAdobe PDF Printable CopyMS Word Copy11/20/24

Additional Dancer Enrollment FormAdobe PDF Printable CopyMS Word Copy6/8/23

Inspection of Premises FormAdobe PDF Printable CopyMS Word Copy8/8/07

Event Notification and Group Travel FormAdobe PDF Printable CopyMS Word Copy9/3/08

Request for CertificateAdobe PDF Printable CopyMS Word Copy7/13/09

Club Sponsored Class FormAdobe PDF Printable CopyMS Word Copy12/12/25

Club Accident ProceduresAdobe PDF Printable CopyMS Word Copy5/9/24

Accident Report FormAdobe PDF Printable CopyMS Word Copy12/12/25

Part 1 and 2 InformationAdobe PDF Printable CopyMS Word Copy11/20/24

Insurance Program Information TrifoldAdobe PDF Printable CopyMS Word Copy5/25

Dancers Code of Ethics and Conduct TrifoldAdobe PDF Printable CopyMS Word Copy8/30/18

USDA Officers and Committees Trifold - IS-07319Adobe PDF Printable CopyMS Word Copy8/1/24

   
 
 

 For Information About USDA Programs, E-Mail at: Info@usda.org

  

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11/12/21