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Water Scenes, Oceans, Rivers, Pools, Piers, Decks, etc.
Students: Read and Complete This Entire Form
GENERAL INSTRUCTIONS:
Use the TAB key or MOUSE click to move from field to field.
CAUTION: Using the ENTER key will automatically submit the form.

PLEASE REVIEW YOUR SUBMISSION BEFORE CLICKING "SUBMIT"
Distribution of Certificates
This is a SPECIAL INSURANCE REQUEST, it may take an additional one to two weeks to process your insurance, so start early.
PLAN ACCORDINGLY!!
GENERAL PRODUCTION INFORMATION

Have you submitted the "Production Registration Form"?:
Yes  No

If you answered "No" this will redirect you to the proper Production Registration Form.

Original Name of Production:

Director's Name (No nicknames. List name as registered with NYU!):
First Name:
Last Name:
Insurance Contact - Email Address:
Email address must be an NYU issued email.
Must end in @nyu.edu. All others will be rejected, and your form will have to be resubmitted.

What Type of Body of Water is this?
Lake River Creek Ocean Pool

How Deep is the Water?:

Any Rapids? Yes No

If Yes, Please Describe:

Where is the Body of Water Located?:
(Please tell us the Town or City and State)


Please give a detailed description of scenes:



Describe Safety Precautions Being Exercised:

If you haven't done this already, please submit a copy
of your script or storyboard to the Insurance Department.
We are located at:
838 Broadway, 4th Floor
New York, NY 10003

If you have an electronic version of your script or storyboard,
you can email it to : insurance.student.film@nyu.edu


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