Insurance Forms

Accident and Illness Insurance Forms

The BSA Incident Report should be completed to report all injuries, illnesses, and incidents that occur during Scouting activities or on council-owned properties that require immediate or potential intervention or a medical provider beyond basic Scout-rendered first aid. Once completed, this report should be forwarded to Natalie Pearce by email or returned at the Golden-Burke Scout Center.

BSA Incident Report

All Crossroads of America Council youth members and registered adult volunteers are covered by the BSA Accident & Sickness Insurance Plan for injuries or illnesses sustained on an official Scout outing. This insurance plan is administered by Health Special Risk Insurance and is in excess of any coverage provided by the injured Scout or volunteer's primary insurance. For questions of the BSA Accident & Sickness Insurance Plan, please refer to the following document or contact Natalie Pearce by email or by phone at (317) 813-7067.

Accident and Illness Insurance Plan Booklet
Accident and Illness Insurance Claim Form
Accident and Illness Insurance FAQs

Certificate of Insurance

Units may request a Certificate of General Liability Insurance from the council. This is a document that gives evidence that the BSA has insurance to cover the claims for which they may be responsible. A Certificate of Insurance can only be issued for an authorized BSA activity. For unit fundraising activities, a unit fundraising application must also be filed and approved. To request a certificate of insurance, complete the request form and forward it to Natalie Pearce by email or return it to the Golden-Burke Scout Center. Please allow seven working days for completion. For certificates naming an additional insured or with special wording, please allow 14 working days. 

Request for Certificate of General Liability Insurance

Tour and Activity Plan

A unit should submit a Tour and Activity Plan for any outing. The unit self certifies their Tour and Activity plan through an online submission process accessed on

The defined reasons and times when a Tour and Activity Plan must be submitted are:

  • Trips of 500 miles or more (one way)
  • Trips outside of council borders, not to a council-owned property, even if less than 500 miles
  • Trips to any national high-adventure base, national Scout jamboree, National Order of the Arrow Conference, or regionally sponsored event
  • When planning a summer camp inside the council boundaries to a location other than one of our council's camps
  • When conducting the following activities outside of council or district events (no matter where or what distance)
    • Aquatics activities (swimming, boating, floating, scuba, etc.)
    • Climbing and rappelling
    • Orientation flights (must also process a flying plan)
    • Shooting sports
    • Any activities involving motorized vehicles as part of the program (snowmobiles, boating, etc.

Tour and Activity Plans have specific requirements for qualified supervision, training, insurance and transportation. For example, CPR and Wilderness First Aid training are required for high-adventure camps. Where swimming or boating is included in the program, Safe Swim Defense and/or Safety Afloat are to be followed. If climbing/rappelling is included, then Climb On Safely must be followed. At least one person must be current in CPR/AED from any recognized agency to meet Safety Afloat and Climb On Safely guidelines. At least one adult on a pack overnighter must have completed Basic Adult Leader Outdoor Orientation (BALOO). At least one adult must have completed Planning and Preparing for Hazardous Weather training for all tours and activities. Basic First Aid is recommended for all tours. Wilderness First Aid is recommended for all backcountry tours.

PLEASE NOTE:  Effective September 1, 2015, the use of 15-passenger vans manufactured before 2005 will no longer be allowed in connection with Scouting programs and activities. Any 2005 or later 15-passenger vans may be used if equipped with Electronic Stability Control and seat belts for all passengers as well as the driver. This applies to all vehicles, regardless of ownership. The use of pre-2005 15-passenger vans could result in there being no BSA insurance coverage available in the event of an accident.

7125 Fall Creek Road North
Indianapolis, IN 46256
(317) 813-7125

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