Add Additional Insured to your Policy

To add an additional insured to your policy, please complete the form below.  We will make every effort to send your certificate within 24 hours.  If you need it quicker then this, call 888-868-1164.

School Information      
Name of School:
Policy # if known: Address:
Name of Person Requesting Certificate: City:
Phone Number: State:
Email Address: Zip:
Additional Insured Information      
Name of Additional Insured:

Attn:
Address:    
City:    
State:    
Zip:    

Do you want the certificate emailed or faxed to you?              Email                     Fax

Email Address:    
Fax Number:    

If you need a second additional insured added to your policy, after you have submitted the form, hit the back button on your browser. Change the additional insured information and resubmit the form.  If you have any questions, you can email us at don@karateinsurance.com or call 999-868-1164.