All brochures need to be created through the Publications Office. Publications will have all brochures approved by the Camp and Clinic Risk Management Team before printing off campus or on campus in the Duplicating Center. Approval of all brochures needs to happen prior to distribution.

All campers must have a completed Youth Event Health & Consent Form (3 pages). This form is provided for you on the UW-Platteville Camp and Clinic website under Camps & Clinics FORMS and cannot be altered. The Hold Harmless, Photo Statement & Consent for Emergency Treatment forms are found on page 3 of the Youth Event Health form, therefore you no longer need to include them in your brochure.

The premium is $1.81 per participant per week, regardless of the hazard level. Seven days of activity constitutes a week. If an event is held only one day per week for several weeks, seven one-day events equals one week of coverage. For an event held for eight days, two weeks of premium must be paid.

If there is a camp held for only one day the charge is $.32 per participant. Camps that are held for two days with no overnight stay involved will be charged $.32 per day per participant for a total of $.64 per participant. Any camps held for three days or more require a charge of $1.81 per participant. If a camp is two days with an overnight stay, the charge will be $1.81 per participant.

These premiums are for 2016 camps.

If you indicate there is insurance in your brochure you need to note that it is LIMITED accident insurance ONLY up to $10,000.


Camps and clinics insurance is purchased by System Risk Management to reduce the potential for liability claims arising out of injuries which occur at the various campus sponsored camps and clinics. This is not a substitute for liability insurance but rather provides “goodwill coverage” for small medical bills incurred by camp participants. These medical expenses must be the result of a covered accident, this is not an illness policy. The policy gives us the ability to pay the medical expenses of camp participants covered under the policy without being negligent, thus reducing the number of claims and suits from participants and their parents. Coverage is primary to State liability insurance and the camper’s personal insurance for covered medical expenses up to $10,000 per student, but is intended to target injuries incurred related to camp activities. It is not meant to cover a student with allergies or a student who is playing with a pocket knife. Coverage can be provided for camps and clinics based on the following criteria:

A. Camps and clinics must be sponsored by a UW campus and open to the public.
B. Premium must be included as part of the registration fee or paid as a gift or grant authorized for this purpose.
C. Only camps and clinics which are oriented toward people who are high school age and younger will be covered.

These are only guidelines to help determine eligibility for the program. If you have a camp or clinic that you feel should be covered and does not fall directly under these guidelines please contact System Risk Management and we can determine if the activity can be covered under this policy.

** Also keep in mind, the coverage is not required but encouraged by System Risk Management to avoid the potential of a lawsuit.

III. Policy Coverage Details

Insurer: ACE American Insurance Company
Medical Benefits: Up to $10,000 per participant for accident medical expenses

There is a limitation for medical benefits in the policy:

a. For hospital room and board, benefits shall not exceed the hospital’s usual charge for its semi-private room accommodations.

The maximum total accident medical payments that can be made to a camp participant is $10,000. This $10,000 includes the limitation discussed above. The insurance company will pay the usual and customary cost for these services actually rendered within one year from the date of the accident up to the $10,000 limit.

Coverage does not apply while any participants are in or on any aircraft.

Accidental Death & Dismemberment:

The other benefits that are covered in addition to the accident medical expenses are:

Percent Loss of Life Accidental Loss of Benefit Amount
(a) Life $10,000
(b) Speech and Hearing $10,000
(c) Speech and one of: Hand, Foot or Sight of One Eye $10,000
(d) Hearing and one of: Hand, Foot or Sight of One Eye $10,000
(e) Both Hands, Both Feet or Sight of Both Eyes or a Combination of a Hand, a Foot or Sight of One Eye $10,000
(f) One Hand or One Foot or Sight of One Eye $5,000
(g) Speech or Hearing $5,000
(h) Thumb and Index Finger of Same Hand $2,500
(i) Quadriplegia $10,000
(j) Paraplegia $5,000
(k) Hemiplegia $5,000
(l) Uniplegia $2,500

Accident Claims Form can be found in the forms link on this website.

1. In the event of any injury, common sense should be used in assuring adequate care is given to the camper. If personal health insurance is available, that may be used in lieu of this policy. Any accident should be reported to the Risk Management Office at the Physical Plant.

2. Upon injury, the injured camper or his/her parent (and physician) must complete a copy of the claim form found under FORMS on this website.

3. The camp director must inform the parent that the completed form must be filed within 90 days of the injury to:

University of Wisconsin-Platteville

Risk Management, c/o Tammie VanNatta

Room 111 Physical Plant

1 University Plaza

Platteville, WI 53818-3099

NOTE: Use the address above and NOT the address on the form.

4. If the injury is severe, and may result in expense greater than $10,000, you must inform Risk Management at 608-342-1188, IMMEDIATELY.


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