Request Coverage

To request first aid coverage, please fill out this form at least two weeks in advance of the event. Please note that submission does not guarantee coverage, and you will be contacted to confirm details and coverage. Please note: CUSERT is unable to cover your event unless it is a Carleton sanctioned event. Please contact the Campus Safety Services to fill out a risk management form for your event.

Event Name(Required)

Location(Required)

Start Date(Required)

Start Time(Required)

End Date(Required)

End Time(Required)

Event Description(Required)

Please provide a brief description of your event.

Attendance Expected(Required)

Organization Group(Required)

Contact Name

First Last

Phone(Required)

Email(Required)

Alcohol(Required)

Yes

Have you completed the risk management form?(Required)

Yes

Special Information

CAPTCHA