Certificate of Insurance Request Form Logo
  • Additional Insurance Request Form

    Insurance for Extended Travel
  • Girl Scouts' Basic Insurance plan covers invited participants who are attending and participating in a Girl Scout activity. Some Girl Scout activities require additional insurance. 

    When Girl Scout groups participate in extended travel, Girl Scouts of NYPENN Pathways requires additional insurance to cover participants in the event of sickness/illness while traveling. The additional insurance is priced to be affordable and is required for 100% of participants for the entirety of the event.

    • For approved travel over 3 nights that takes place more than 3 hours from home or in another state, groups must purchase the 3P Insurance plan ($.70pp/day) that includes illness/sickness primary insurance in addition to supplemental accident insurance.
    • For approved international travel (including Canada), groups must purchase the 3PI plan ($1.17pp/day) that includes international illness/sickness primary insurance in addition to supplemental accident insurance.

    Please submit requests at least 3 weeks prior to the travel date and after the travel is approved

  • Requester Information:

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  • Extended Travel Insurance Information:

    Trip must be approved prior to purchasing additional insurance for an extended trip. 

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  • By submitting this request you are authorizing Girl Scouts of NYPENN Pathways to provide your troop or service unit bank account information to Mutual of Omaha for the total amount due.  

    The receipt will be emailed to you the day your request has been processed. If you have any further questions, please contact:

    info@gsnypenn.org or call us at 607.442.4863 or 1.800.943.4414 

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