Insurance Forms

When a player receives an injury during participation in a Kemptville District Soccer Club program some financial assistance may be available.

If the injury occurs during an OSA sanctioned game (a game with a center referee assigned to the game) the injured player is advised to obtain a copy of the Game Sheet and of the Special Incident Report from the Club or League.

The Club does not submit claims on behalf of members, but will assist in any way possible.

To view a document on the Insurance Claim Process with an Accident Claim Form and Attending Physician's Statement Form please click here

For more information please email club@kemptvillesoccer.com.