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Applications / Forms

DTHA - Delaware Thoroughbred Horsemen's Association
2007-2008 DTHA Application
     1) DTHA Workers' Compensation Application

CHSA - California Horsemen Safety Alliance

2007-2008 CHSA Application & CTBL Participation Agreement
     1) CHSA Workers' Compensation Application
     2) California Thoroughbred Participation Agreement

Claims Administration - Jockey Accident & Health Claim Forms

- 1st Report of Injury Form (Click Here For Read/Print Only Version)
- Temporary Disability Form (Click Here For Read/Print Only Version)
- Supplemental Disability Report (Click Here For Read/Print Only Version)
- Accidential Death Form (Click Here For Read/Print Only Version)
- Dismemberment/Paralysis Form (Click Here For Read/Print Only Version)

General Claim Forms
- General Incident Report (MS Word Version) (Read/Print Only Version)
- Supplemental Auto Incident Report (MS Word) (Read/Print Only Version)
- Real Estate Incident Report (MS Word Version) (Read/Print Only Version)
- Theatre Incident Report (MS Word Version) (Read/Print Only Version)

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