Risk Management


Forms, Brochures and Information for Athletes

LACCD 2020-2021 Student Accident Insurance website: https://agadministrators.com/laccd

Athletic Student and On-Campus Accidents, Procedures and Claims

LACCD 2021-22 Claim Form QBE Final.pdf2021/2022 Intercollegiate Sports & Student Accident Claim Form

LACCD 2021-22 Claim Form QBE Final.pdf2021/2022 Student Accident Insurance Brochure

On-Campus Accident Brochure, 2012/2013

On-Campus Accident Brochure, 2011/2012

2019-2020 Student Insurance Brochure

LACCD 2020-21 Student Insurance Brochure

LACCD 2020-21 Student Accident Claim Form

LACCD 2019-20 Student Accident Claim Form

2020-21 LACCD Accident Insurance Card.pdf2020-21 LACCD Accident Insurance Card

2020-21 LACCD Aerogami Flyer.pdf2020-21 LACCD Aerogami Flyer

2019-20 LACCD Keynect Up Flyer Student Insurance

How to get and use he digital ID card with an Android (e.g. LG or Samsung) 

  • Please download the Google Lens app

  • Scan the QR code on the brochure

  • You should be prompted to open and save the contact information in your device's Contacts

  • The ID card (in your Contacts) should have a link to ACI's claim filing instructions  


Athletic Waiver Form

 2013 Athletic Waiver Form (now one form for all campuses)

Authorization to Release Medical Information Forms

East LA College 

Pierce College

Southwest College

Trade-Technical College 

Valley College 

West LA College


General Property and Liability Documents and Forms


General Participant Waiver Form


This general waiver form for participants in LACCD/College events or activities is intented to be filled out for the appropriate event for which participation is sought. If you have any questions, please contact Sherri Beloney-Hatcher at the number (5213) 891-2330

LACCD Driver Data form

If you have questions, please contact:
Sherri Beloney-Hatcher
(213) 891-2330



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