Insurance Forms

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Every Pop Warner organization is required to carry insurance for the following reasons:

  1. Players, cheerleaders, coaches, volunteers and spectators may become injured and require insurance to cover medical expenses.
  2. Valuable equipment and other property can become damaged, destroyed or stolen, and insurance covers the value or replacement of that property.
  3. Volunteers may not handle funds honestly and insurance can protect from that dishonesty.
  4. Volunteers and their organizations can be sued for a variety of other reasons and may require insurance.

Since insurance is of vital importance to the success of the programs, an Insurance Coordinator should be appointed who will spend considerable time on this major responsibility.


(For Tackle, Flag Football and Cheerleading Activities)

Pop Warner offers low-cost, broad insurance coverage as a benefit to its members. The Plan is specifically written to meet the needs of Pop Warner Little Scholars. The Pop Warner Insurance Committee, in conjunction with its Broker, periodically reviews the cyclical insurance marketplace to obtain the broadest possible coverage at the most competitive price. The Official Insurance Plan Brochure is updated annually, typically, in late April of each calendar year.

Pop Warner is well positioned, based on its 80+ year history, national scope and impressive safety record, to secure competitive rates and comprehensive coverage while maintaining an excellent reputation and close working relationships within the insurance marketplace. All insurance carriers participating in the Pop Warner Insurance Program are rated either A+ or A by A.M. Best.

Please Note: Pop Warner Insurance has the concussion insurance included in the rates listed below in the enrollment packets.

Types of Coverage Available under the Program:

-Excess Accident Medical Expense Insurance:
-Liability Insurance:
-Equipment and Property Insurance:
-Blanket Fidelity Bond:
-Directors & Officers Liability Insurance:

Pop Warner Insurance Forms:

 2016 Insurance Enrollment form – Medical & Liability

Excel  Insurance Enrollment form – D&O and Bond

 Season Medical Claim Form

 Season Liability Claim Form

  Credit Card Payment Authorization

  2016 Camp Insurance Enrollment


K&K InsurancePop Warner Little Scholars, Inc., provides excess accident coverage for registered participants through K & K Insurance. The excess policy covers accidents that occur during sponsored activities and is secondary to the participants' group medical insurance.

When a player is injured, the claim must first be submitted to the primary insurance. As soon as possible after an accident, the injured player, or parents, if the player is a minor, fill out an K & K Claim Form (above).

A representative of the league, coach or league official, must complete and sign Section A of the claim form. This is for verification purposes to confirm that the player was injured while participating in a sponsored event. The injured player, or parent, must complete and sign Section B.

Submit the completed K & K form, itemized medical bills (balance due statements are not acceptable) and the primary insurance explanations of benefits to the K & K claim office address on the form. If the injured player has no other insurance, that information must be noted on the claim form. The K & K policy becomes primary in the absence of other valid insurance.

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