GCFM Club Insurance
Sign up March 15, 2013 through April 15, 2013
Coverage effective June 15, 2013 through June 14, 2014
WHAT IT COVERS: The policy offered to clubs through GCFM is a “Premises” policy. It covers clubs,
members and visitors as well as the meeting space. In addition, the policy covers club sales and
special events as long as alcohol is NOT served.
RATE: The rate for this coverage is $2.50 per actively Participating Member. An active member is one who attends one or more meetings or other club events in a given year.
PAYMENT: Sent checks to the GCFM Office, 219 Washington Street, Wellesley Hills, MA 02481.
Make checks payable to GCFM and indicate “Club Insurance” on the bottom of the check to ensure your payment is properly credited. Include the form below with your payment.
Please note this is the only time of the year you will have the opportunity to purchase or renew Club Insurance through the Federation. This notice is included in emails to each club President, the March/April Mayflower and on GCFM’s web site.
GCFM
CLUB INSURANCE SIGN-UP FORM
Sign-up period: March 15 to April 15, 2013
Insurance effective dates: June 15, 2013 through June 14, 2014
Club name:
________________________________________________________________
Treasurer: ________________________________ Email: __________________________
Address:
__________________________________________________________________
__________ Number of actively participating
members at $2.50 each
$
______________ Total amount
due. Please make your check payable
to GCFM /Club Insurance.
Mail this form
to: GCFM Office, 219 Washington
Street, Wellesley Hills, MA 02481
QUESTIONS ? Contact Betty Sanders, Second Vice President at
betty02052@gmail.com or 508-359-9453
Printable Form