Version 1.1 Updated September, 29 2008
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Senate for Student Organizations
CLUB TRAVEL,
RISK MANAGEMENT &
INSURANCE PACKET
Version 1.1
Updated September 29th 2008
Version 1.1 Updated September, 29 2008
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Table of Contents
Risk Management
Introduction ........................................................................ Pg. 3
Club Activity/Event Planner............................................... Pg. 3-4
Club Domestic Travel......................................................... Pg. 5
Club International Travel ................................................... Pg. 6
Participant Medical Release Form ..................................... Pg. 7
Club Insurance
Introduction ........................................................................ Pg. 8
Coverage Limits ................................................................. Pg. 8
How to Gain Coverage for Members ................................. Pg. 9
Detailed Coverage Information
General Liability Coverage ...................................... Pg. 9-10
Excess Basic Accident Medical Coverage ............... Pg. 10
Catastrophic Injury ................................................... Pg. 10
Exempted Club Activities................................................... Pg. 10-11
Additional Certificates........................................................ Pg. 11
How to File a Claim ........................................................... Pg. 11
Contact Information............................................................ Pg. 11-12
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Version 1.1 Updated September, 29 2008
RISK MANAGEMENT
Risk management is a critical aspect in keeping our club system at Central safe, fun and
enduring. It is very important to take the time when planning an event to identify
possible risks that will arise and develop strategies to go about safely minimizing them.
Club Advisors should take an active part in helping students manage risk by reviewing
and aiding in the planning for future club events and activities. In an effort to help our
Clubs and Organizations effectively conduct risk management, the following worksheet
has been developed for usage when planning club events and activities. Extra copies of
the below form may be picked up in SURC 236, or available online at
www.cwuclubs.com. For questions or assistance please feel free to contact the VP for
Clubs and Organizations.
Club Activity/Event Planner and Safety Form
Type of Activity (e.g. open activity):
Activity/Event Name:
Club Name: _________________________________________________________________________
Goals: _____________________________________________________________________________
___________________________________________________________________________________
___________________________________________________________________________________
Date:
Meeting Time:
Beginning Time:
Ending Time:
Description of Activity:
Timeline of Activity:
Meeting Place of Activity:
Cost per Person:
Minimum Participants Required:
Place of Activity:
Breakdown of Costs: _______________________________________________
Maximum Participants:
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Transportation: ______________________________________________________________________
Contact Information during Activity (names and phone #s): ____________________________________
________________________________________________________________________
________________________________________________________________________
Contact Information of everyone involved in planning process:
List of Items to Bring:
Possible Safety Meeting Dates: (1) _________________ (2) _________________ (3) _______________
Potential Risks
Student Club President’s Signature:
Strategies to Deal with Risks
Date:
(1) No Problems (2) Comments: ____________________________________________________
___________________________________________________________________________________
Actual Date of Meeting and Meeting Content:
(Please attach write-ups of any additional meetings you may have had)
Advisor’s Comments: (1) No Problems
(2) Comments: _________________________________
___________________________________________________________________________________
Advisor’s Signature: __________________________________ Date: _________________
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CLUB DOMESTIC TRAVEL
There are many times when a club has the opportunity to travel domestically within the
United States. Such opportunities might consist of a regional or national conference, a
trip to do service and out reach, a sporting event or regional competition. These types of
trips are highly anticipated by students and are often very meaningful and memorable
experiences and clubs are highly encouraged to take part in them.
However, when embarking on Domestic Travel, certain steps must be taken in planning
your trip and notifying the proper administrators to ensure the safety of all participants in
the case of an emergency. For future reference, Domestic Travel will include all travel
outside of Kittitas and Yakima Counties.
One of the most important factors when traveling domestically is to notify the proper
university officials of who, where, when, and how your club is traveling. It is also vital
to gather contact information so that in the case of an emergency or natural disaster
university officials and/or relatives are able to quickly establish contact and provide any
necessary assistance. For these reasons, it will be REQUIRED for all clubs that are
traveling domestically to complete the “TRAVEL ITENERARY FORM” and submit the
completed form to Campus Life in SURC 269 prior to embarking upon the trip. Copies
of this form shall be kept in the ASCWU Office in SURC 236, and online at
www.cwuclubs.com. ***Please note that if your club is requesting funds from Club Senate to pay for
part or all of the trip, the “Travel Itinerary Form” is already part of the required Funds Request Form.
Highly encouraged, is that traveling club members complete “PARTICIPANT
MEDICAL RELEASE FORMS” and give to the team leader on the trip to have on hand
in case of emergency. These forms will allow university staff or club members on your
club trip to seek emergency medical services for club members should they become
injured. It also has medical insurance and contact information as well which will aid
emergency service providers in treating the injured club member/s as quickly and
efficiently as possible.
As part of the trip planning process, it is also recommended that clubs work with their
advisor to conduct a Risk Management Assessment of the event by completing the
“CLUB ACTIVITY/EVENT SAFETY FORM” as presented earlier in the packet.
If a club is traveling domestically to an isolated, remote or recent disaster stricken area
(such as New Orleans following the destruction from Hurricane Katrina), club officers
and advisor should contact the VP for Clubs and Organizations as there will be some
additional requirements when receiving state funds for approved travel such as required
accompaniment of a university official as well as a more established plan to ensure
regular communication, tracking and the approval by a university vice president or
designee.
Again, all of the necessary required and recommended forms are available in the
ASCWU-BOD office (SURC 236) and online at www.cwuclubs.com. Please feel free to
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contact the VP for Clubs and Organizations with questions when planning any type of
Domestic Travel.
CLUB INTERNATIONAL TRAVEL
There are rare occasions when clubs have the opportunity to travel internationally. When
these occasions arise, club leadership and advisor should contact the VP for Clubs and
Organizations as there will be additional requirements when receiving state funds for
approved club travel internationally. Some of these additional requirements will include
further tracking mechanisms and trip planning requirements for increased safety and also
the approval of the President of Central Washington University or his/her designee as
required by University Policy.
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PARTICIPANT MEDICAL RELEASE FORM
PARTICIPANT INFORMATION:
Participant's Name: ____________________
Date of Birth:
/
/
Address: _____________________________
Home Phone: (____) _______________________
City: ______________
State: _____
Zip:
_______
Guardian name(s) if participant is a minor: ________________________
Father's Work (____) _____________ ext: ____Mother’s Work (___) _____________ext.____
Father's Cel1/Pager: (____) _____________Mother's Cel1/Pager: (___) ______________
Secondary Person to Contact in case of emergency (Adult of another household):
Name___________________________________Phone:____________________________________
Health & Medical Information
Family Physician: __________________________
Physician's Phone: ______________________
Insurance Company: ________________________
Policy #:__________________________
Please list any allergies/medical problems/disabilities:
_______________________________________________________________________________________
List any physical restriction for any activity on the basis of medical condition:
______________________________________________________________________________
________
______________________________________________________________________________________
Allergy or reaction to any medication or food?
Yes No
If yes, please list. _________________________________________________________________________
I certify that I am physically capable of participating in all of the club activities, and I know of no medical or
health reason which would prevent me from participating safely. I give permission for University staff,
employees or student club representatives to seek emergency medical services for me should I become injured
or ill with the understanding that I will assume full responsibility for any and all medical expenses which may
be incurred as a result of an accident or illness.
_________________________
Print Name
________________________
Signature
________________
Date
If the participant is under the age of 18, the signature of a parent or guardian is required below.
_________________________
Print Parent’s Name
-
-
________________________
Parent’s Signature
_________
Date
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CLUB INSURANCE
All Recognized ASCWU-BOD Clubs Councils and Boards are covered under a blanket
insurance policy that includes General Liability Coverage, Excess Basic Accident
Medical, and Catastrophic Injury coverage. It is very important that your club leadership,
advisor and individual club members are fully informed about our insurance to ensure
that you are managing new members and conducting your events properly to qualify for
coverage in the event of a claim. Each policy listed below has specific limitations and
exclusions that apply. It is also critical to be educated on what can and cannot be
covered, what the coverage limits are and also the proper steps in making an insurance
claim so that full benefit is utilized if need arises.
COVERAGE LIMITS:
Associated Students of Central Washington University
Clubs, Councils & Board
Insurance Coverage (2008-2009)
Type of Coverage:
General Liability
Excess Accidental
Catastrophic
Insurance Limits
Maximum Coverage:
General Liability Aggregate Limit
Products/Completed Operations
Aggregate Limit
Personal Advertising Injury Limit
Participant Legal Liability Limit
Each Occurrence Limit
Fire Damage (any one fire) Limit
Medical Expense Limit
$2,000,000
$2,000,000
Accident Maximum
$1,000,000
$1,000,000
$1,000,000
$50,000
$5,000
$25,000
Accidental Death and
Dismemberment
Dental
Outpatient Physical Therapy
Outpatient Orthopedic Appliances
$10,000/10,000/5,000
Catastrophic Injury
$5,000,000
Deductable:
None
$100
Corridor
$1,000
$500
$500
$25,000
(Provides benefits only after the
Excess Accidental Max has been
exhausted)
$10,000 (Provides benefits
only after the Accidental Death
has been)
***Please note that this insurance policy is secondary to any personal insurance that
individual club members are currently protected under.
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HOW TO GAIN COVERAGE FOR MEMBERS:
The ASCWU-BOD in conjunction with the Services and Activities Committee has
approved the premium payment for coverage which provides for this valuable insurance
coverage for all participating members of clubs and organizations. HOWEVER,
COVERAGE IS NOT EXTENDED AUTOMATICALLY! Clubs must first become
recognized by the ASCWU-BOD and then, EACH club member must sign a liability
waiver when joining as a member to take advantage of this free insurance. Failure
to do so will result in zero coverage for those members who do not sign the waiver.
DETAILED COVERAGE INFORMATION:
GENERAL LIABILITY COVERAGE:
What does the general liability actually cover??
Listed below is a summarized list of what our general liability coverage extends to. For
more detailed coverage information than is listed below, please contact the club insurance
coordinator.
General Liability
This coverage protects your club from claims arising from alleged bodily injury, personal
injury or property damage liability. It includes protection for services you render or
products you sell with limitations for certain products. Coverage may include judgments,
attorney fees, court costs or other related expenses. Policy limitations and exclusions
apply to all claims under this section.
Personal and Advertising Injury Liability
This coverage is used to insure against claims of libel, slander, product disparagement,
piracy, infringement of copyrights, etc. that arise out of the advertising of your goods,
products or services. Policy limitations and exclusions apply to all claims under this
section.
Medical Payments
This coverage may reimburse, without regard to your liability, all reasonable medical
expenses incurred by third parties as a result of bodily injury sustained by accident as
defined in policy. Policy limitations and exclusions apply to all claims under this section.
Premises/Operations
This coverage is used to insure against claims arising out of your ownership, maintenance
or use of premises including any operations that are in progress. Policy limitations and
exclusions apply to all claims under this section.
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Products/Completed Operations
This coverage is used to insure against claims arising out of bodily injury and property
damage that result from products sold, manufactured, handled, distributed or disposed of;
or for work you have performed, provided the accident occurs away from premises you
own or rent. Policy limitations and exclusions apply to all claims under this section.
EXCESS BASIC MEDICAL ACCIDENTAL COVERAGE:
Benefits for Medical Expense will be paid only for such expense which is not recoverable
from any other insurance policy, service contract or workers’ compensation. When
covered Injuries result in treatment by a legally qualified physician within the timeframe
indicated in our policy, coverage will include medical expenses incurred in excess of the
$100 medical deductible. Benefits shall not exceed the usual and customary charges.
Eligible Medical Expenses are as follows:
(a) Treatment by a legally qualified physician;
(b) Care or services from a hospital or ambulatory surgical center;
(c) Services from a registered graduate nurse (RN or LPN) not related to the insured
by blood or marriage;
(d) Professional ambulance service;
(e) Orthopedic appliances
Policy limitations and exclusions apply to all claims under this section. Please call the
Club Insurance Coordinator for more information or to file a claim.
CATASTOPHIC INJURY:
Catastrophic Injury Coverage will extend to all major medical costs that exceed the
$25,000 maximum outlined in special risk accidental. Catastrophic Injury also includes
an accidental death and dismemberment benefit of $10,000. Policy limitations and
exclusions apply to all claims under this section.
Please note that Individual Car Coverage for trips directly related to participation in a
covered activity is covered (with conditions). You will be required to show current
evidence of insurance on the vehicle to be used and that the minimum coverage amounts
required by the governing jurisdiction are in force. Driving records of the drivers are
expected to be satisfactory and a formal approval process for use of private vehicles prior
to each trip is required. Your club must also be receiving some form of reimbursement
for travel expenses though club senate to apply.
EXEMPT CLUB ACTIVITIES:
The general liability policy will not cover the following activities:
Assault And Battery, Corporal Punishment, Abuse/Molestation, Asbestos,
Discrimination, Nuclear Energy, Total Pollution, Total Fireworks/Pyrotechnics,
Employment Related Practices, Organic Pathogens, Punitive Damages, War, Lead
Liability, Stunt Activity, Use Of Trampolines, Use Of Saunas Or Tanning Devices, Polo,
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Skin And Scuba Diving, Squash, Snow Skiing, Water Skiing, Whitewater Rafting,
Bungee Jumping, Mountain Climbing, Rock Climbing, Motorsports, Rodeo Or Any
Equestrian Related Sports, Waterslides, Ballooning, Parachute Jumping, Luge,
Tobogganing, Gymnastics, and Mechanical Riding Devices.
As a result, it is important to note that the above listed activities shall not ever be
sanctioned as official club activities unless the club is participating in them through
an outside licensed and insured provider. Proof of coverage will be required prior
to the club or activity being recognized or authorized by the ASCWU. A valid
certificate of insurance naming the Associated Student Body of Central Washington
University, the State of Washington and Central Washington University shall be
submitted with either the club application or funds request packet. Certificates of
insurance can also be faxed to 509-963-1685.
ADDITIONAL INSURED CERTIFICATES:
If your club is hosting an event off-campus, some businesses and facility rental
agreements may require “Additional Insured Certificates”. Additional Insured means that
the premises or business that you are holding the club activity at will also be covered
under this policy for general liability protection. To better protect this policy, it is
suggested that clubs limit the amount of exposure given to your Additional Insured by
naming a specific activity and location for which they are being added. On a proof of
insurance Certificate, the Additional Insured statement will only be present when you
specifically request it. For more information about obtaining Additional Insured
Certificates, please contact the Club Insurance Coordinator. Please note that Additional
Insured Certificates cost $35.00 each.
HOW TO FILE A CLAIM:
If you, a member of your club, or an attendee becomes injured at an event, or encounters
a possible claim related scenario, please contact the Club Insurance Coordinator as
quickly as possible as there are time restrictions for submitting the proper paperwork
when filing a claim. If you are unable to contact the Club Insurance Coordinator, please
directly contact John Drinkwater, Senior Director of Campus Life ; Nick Peacock, VP for
Clubs & Organizations; or Keith James, VP for Equity and Community Service for
assistance.
CONTACT INFORMATION:
For Emergency Services .......................................................Dial 9-1-1
Insurance Questions or Claim Information
Dan Sweeney, Club Insurance Coordinator ...........................509-963-1735
(sweeneyd@cwu.edu)
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Other Important Phone Numbers
John Drinkwater, Senior Director of Campus Life ................509-963-1686
Kay Davis, Campus Life Accounting ....................................509-963-1329
Nick Peacock, VP for Clubs & Organizations .......................509-963-1682
Keith James, VP for Equity and Community Service............509-963-1697
ASCWU-BOD Front Desk (Student Government)................509-963-1693
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