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Barrington Area

Soccer Association

Barrington Area Soccer Association

Secondary Insurance Claim Form

To submit a secondary insurance claim to Illinois Youth Soccer Association, you MUST do the following  (2) TWO steps:

Step 1. IYSA INSURANCE CLAIM FORM (CLICK LINK BELOW)

IYSA Insurance Claim Form 

NOTE: Once this has been filled in BASA/FCX will send the form to IYSA. Please email [email protected] once completed. 


Step 2. PULLEN INSURANCE SERVICES (CLICK LINK BELOW)
Pullen Insurance Services

NOTE: Must be filled out along with IYSA Insurance Claim Form before your claim can be filed.