Please fill this form out immediately (within 48 hours) of the accident. Once completed please save to your computer and email a copy of the form to
. If this is not completed and sent to us at the email address mentioned above within 48 hours, we can not guarantee that your claim will be processed. Please follow all instructions attached to the form. DO NOT SEND THIS FORM TO K & K Insurance. IT WILL NOT BE PROCESSED. THIS FORM MUST BE SENT TO
IN ORDER FOR IT TO BE. PROPOERLY PROCESSED.
Any questions regarding this process or the forms should ONLY be directed to Copiague Youth League, Inc. via our email