• Work In Progress

    This web site is a work in progress. Until notified to do otherwise, please continue to use the current CSSDA web site at http://ColoradoSquareDance.com as the official Colorado Area Square Dancing web site. Please take a look at this site.  If you see problems, please write down the page and problem and provide feedback to Ervin Wyatt at This email address is being protected from spambots. You need JavaScript enabled to view it..

USDA Insurance (2018)

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INSURANCE
2018 ENROLLMENT INSTRUCTIONS

  To apply for USDA Insurance your club will need to complete
 the following forms by DECEMBER 1, 2017. Remember that 100%
of your club members must be insured for
 your club to qualify for this insurance.
The forms you need to submit are:
          The CLUB ENROLLMENT FORM
          THE CLUB ROSTER FORM
          THE DUAL MEMBER ENROLLMENT FORM
the number one issue that could delay your coverage is dual memberships. Be sure to verify that the dancers you list as members of another club are covered by that club. If that club's roster does not include them, then your forms will be sent back to you. The easiest way to insure prompt issue of your certificates is to pay the premium for every member, including the dual members.
Because we travel each year until about December 5th, I have extended the deadline to receive your documents and you mayEMAIL me your enrollment form, your roster, and dual member list anytime in the month of November,  Below are the instructions on what to do:
1. Prepare your three documents
2.  Email those three documents in November to This email address is being protected from spambots. You need JavaScript enabled to view it. I  will respond to your email so that you know I received your documents.
3.  I will review the documents and notify you of any discrepancies.
4. I will then make all the copies to be sent to national, set them aside for mailing the first of December..
5.  YOU WILL SEND BYSNAIL MAILTO ME, YOUR CHECK for 4.75 PER DANCER MADE OUT TO CSSDA INSURANCE   Linda Goble   61 LeConte Drive, Livermore CO 80536.   If your club check is in my mail box when I return, your documents will then be mailed to Nationals   All USDA insurance documents ae available on this WEB SITE. 
THANKS
LINDA GOBLE
CSSDA INSURANCE CHAIRPERSON
970 498 8997


MEMBERSHIP ROSTER INSTRUCTIONS

ENTER ONLY ONE PERSON ON EACH LINE
ENTER ALL THE MEMBERS OF YOUR CLUB.
DRAW A LINE THROUGH THE NAMES THAT
ARE TO BE COVERED BY ANOTHER CLUB
(remember to verify that fact)
ADD THE DRAWN OUT NAMES TO THE
DUAL MEMBER ROSTER.
ADD THOSE THAT YOU ARE PAYING FOR AND
SEND A CHECK FOR 4.75 EACH
 


DUAL  MEMBER ROSTER 2018

Some clubs have members that belong to
more than one club.  The dancer only needs
to be enrolled in the program by one club, not all.
However, if you have a dancer that belongs to more than
one club, you must determine between the clubs, 
which club will be providing the insurance
.
Not verifying the information is the ONE MAIN REASON THAT
POLICIES ARE DELAYED.  

If you declare a member as a member of another club,
you must list their name and the name of their other club on the
dual member roster.
  That other club must have listed them on their
main member roster and paid the premium.

Some clubs in order to avoid errors, just choose to
list and pay for  their member and avoid  any
extra work.
Download the form by clicking on the button below.
MAal it with the rest of your enrollment documents.

DO YOU NEED A CERTIFICATE OF INSURANCE?
When you enroll in the program each year,
you will receive a certificate for each
facility that you listed on your enrollment form.

You will need to request additional certificates if your have changed
your dance venue, either permanently or temporarily.
Fill out the form found in the download button below and send to
Linda Goble at
This email address is being protected from spambots. You need JavaScript enabled to view it.
970 498 8997
Your venue will NOT be insured without this certificate


DO YOU HAVE A NEW MEMBER?
If so, you must enroll them in your insurance policy. 
Fill our the new member enrollment form and mail
it and  $ 4.75 per new member to

the CSSDA Insurance Chairperson.
L
inda Goble    61 LeConte Drive  Livermore CO 80536
This email address is being protected from spambots. You need JavaScript enabled to view it.    970 498-8997

Click on the download button below to
get the form

CLASS/STUDENT ENROLLMENT FORM
NO PREMIUM REQUIRED

THIS FORM CAN BE USED FOR BOTH 2017-2018

You must insure your class members in order for them to be covered under your policy.
Please submit this form listing all new dancers in your class.
There is no premium due for students.
Your students should be told that they will only be insured by you for 30 days
following their graduation.
They must then join a club that is  insured by the USDA/CSSDA
in order to have continued coverage.
YOU MAY EMAIL ME THIS FORM TO SAVE TIME.
This email address is being protected from spambots. You need JavaScript enabled to view it.           970 498-8997

SPECIAL EVENT AND/OR TRAVEL NOTIFICATION

This is the form that you will use if your club and its members plan an
activity other then your regular dance schedules and venues.  
Please note:The USDA Insurance Policy never covers activities
or dances that are held at a private residence.

EMAIL the form to:   Linda Goble      This email address is being protected from spambots. You need JavaScript enabled to view it.
Click on the DOWNLOAD button for the form


 

USDA  CLUB ACCIDENT PROCEDURES

The USDA has published the attached document to help
your club work through the process of reporting and  following
up on an an accident report. Just click on the download for that
document.
ACCIDENT REPORT FORM

If your club has an accident, please use this form 
to report the accident within 48 hours of the
event.  Send the form even if you do not yet
have all the details.
You may send it by email or snail mail
Linda Goble
61 LeConte Drive Livermoe CO 80536
This email address is being protected from spambots. You need JavaScript enabled to view it.
   970 498-8997