When a player is injured at the facility, that player or that player's
parent or legal guardian must complete an injury
report. You must print a form and fill it out.
Please complete the form entirely. Directions are included on the last page
of the form.
An incomplete form may hold up the processing of your claim. Turn in
the completed form to the Director of Operation.
The Director of Operations reviews this form and then you will mail the
form to our Insurance Company:
Bollinger Insurance
P. O. BOX 390
SHORT HILLS, NJ 07078-0390
TELEPHONE (800) 526-1379
Ask for Sports Claims
Do not send any medical bills to KISS. Once YOU submit your paperwork to the
insurance company, we are out of the picture.
Thank you for your cooperation.
