Please fill out the ACA’s insurance request form ,which is required for all class 3 and above trips (since river class is very subjective, class is determined by American Whitewater), as listed below.
By being consistent you assure that standard procedures are used and expedite the approval process.

Once approved you will get an approval ‘Insurance Request Form’ email from the ACA which should be forwarded to .

Organization Name * Kayak and Canoe Club of New York

Address Line 1 * , State *   and Zip *    Use your (coordinators) contact info. Nothing is normally mailed and KCCNY does not have a corporate address.


Email *

Organization Website

Event Organizer Information

Event Organizer Name *, Event Organizer Email *, Event Organizer ACA Number * and Event Organizer Phone * should obviously be your/event coordinator’s info.

Event Information

If the river appears on copy information as much as possible as ACA likes constancy.

Event Name * copy river name from

Event Description * copy from approved rivers page.

Event Start Date *   and Event End Date *    (If event might happen on multiple days like, for example, you’re hoping for natural flow and don’t know if Saturday or Sunday will be better, put in the range).

Estimated # of Spectators * needs to be a # so pick one. (Below, in spectator management we mention that they don’t have anything to do with us).

All river information should be copied from our rivers page or, if the this is a new class 3 or above river, please do your research. If you believe changes should be made to a river on  our rivers page contact the safety chair or resubmit our river submission form.

Venue / Waterway * Copy river name from our rivers page.

River Classification * , Nearest City and State * Copy  from our rivers page.

Minimum Water Flow Level *, Maximum Water Flow Level *  Guess but do not exceed what is listed on our rivers page or American Whitewater.

Event Safety Plan

Event Safety Coordinator * Normally the coordinator, but another qualified expected participant could be listed.

Staff & Volunteers *   1 (or more, a number is required)

Site Inspection *      Attempts will be made to determine any new hazards via online research such as American Whitewater and online forums. As mentioned in safety plan, the most experienced paddlers will take the lead thru difficult sections.
Shore based scouting will be used as needed.

Relaying Information *      Trip will be run as a single group, with all paddlers attempting to stay within sight of the next paddler, especially thru difficult sections. Standard river hand signals will be used if needed.

Medical Emergencies *      Please copy hospital and urgent care info from . (For rivers not listed, a little online research can usually determine where the nearest emergency rooms and urgent cares are and how to contact first responders. Though this takes some time, it is really something you should know).

Emergency Vehicles *  and Emergency Vehicle Information. Normally  0.   

Evacuation Plan *      Please copy evacuation info from .
(For rivers not listed, a little online research can usually determine if and where evacuation is possible. Though this takes some time, it is really something you should know).

Safety Boats * Yes

How Many Safety Boats? 1 or more

How will safety boats be utilized? KCCNY club trips are characterized by all the paddlers contributing what knowledge and experience they possess towards the group’s fun and safety on the river. Any participant who does not have the proper safety equipment at the start of the trip will be asked to leave the group by the trip coordinator.

Through difficult sections the most experienced boaters are encouraged to take the lead (probe) and to end (sweep) thus ensuring that paddlers are in place to lend assistance and ensure that all paddlers can safely navigate difficulties.
In addition, KCCNY provides financial assistance for swift water rescue training.

Shelter * (Normally) none

Facilities *      (Normally) none

Spectator Management *        Event will take place on a public waterway. Spectators are possible but will not be affiliated with our trip.

Media Promotion Plan

Media Plan Details * Event will be posted on and may be promoted via mass email or FaceBook posting or other social media

We do not post the time or meeting place of trips because we want potential participants to contact the trip coordinator in advance and discuss their qualifications and abilities and preparedness for the conditions expected to be encountered. Participants are responsible for discussing the trip candidly with the trip coordinator in order to make a determination as to whether the trip or event, at the expected water levels and weather conditions, is appropriate for them.

Agreement with Submission:

Additional Insured Certificates *       Normally none, except for pools.

If Yes, How Many? na

Date Certificate Is Needed *  na

Additional Information           na

Signature  *