USSSA - United States Specialty Sports Association

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MISSION / VISION Statement

Empower our team and its partners with an unsurpassed platform to create and support world-class athletic events and sports programming to enrich and educate the lives of participants at all levels.

Core Values:

We believe that Integrity is the foundation of our actions.
Passion energizes our purpose.
Mutual respect for one another drives Teamwork.
We are Committed to the success of our stakeholders.
Accountability and 100% engagement is the key to our future.

United States Specialty Sports Association Insurance Program

Note: There is an additional $10 charge for online processing.

Age Group determined by the age of the oldest child on the team at the time of purchase.

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Team Name:

USSSA Team Registration Number:

Contact First Name:

Contact Last Name:

Contact Address:

Contact City:

Contact State:

Contact Zip Code:

Contact Phone:

Contact Email Address:

Complete items below only if field/facility owner requests additional insured status. Below there are text boxes to add one field/facility owner. If you have more then one field/facility owner, please email requests for additionals to insurance@usssa.com. Make sure you include your team name and payment confirmation number with the additional field information. You will receive this confirmation number after paying online.

Name of Field/Facility Owner:

Address:

City:

State:

Zip Code:

Contact Person:

Phone:

I hereby certify the above information is correct and the team is USSSA registered

Please complete the missing fields of the form