Frazier Insurance Agency > International Snowmobile Racing

General Information

ISR Sanction Number:
Club Name:
Event Organizer:
Contact Name:
Named Insured:
Mailing Address:
City:
State:
Zip:
Home Phone:
Work Phone:
Fax:
E-Mail:

Event Information

Type of Event:
Date(s) of Event:
Set-up Date(s): (24 hours prior)
Tear-down Date(s): (24 hours from last event)
Testing Date(s):
Course Location:
Address:
City:
State:
Zip:
Additional Insured:
Address:
Mail Certificate? Yes No
Additional Insured:
Address:
Mail Certificate? Yes No
Further additional insureds must be submitted by supplement.
Total Anticipated Spectators:
Total Anticipated Participants:
Liability Limit:
Participant Accident Limit:

Premium Computation

Race Day:
Second Race Day:
Additional Race Days:
Total:

Reporting

Each scheduled event must be reported at a minimum of 48 hours prior to actual day on which the scheduled event or events are to take place, and premium must be paid at the time of the report as evidenced by United States or Canadian postmark. There are no exceptions to this rule.
In the event of a rain-out/snow-out, or if the race is postponed for any reason, notify Frazier Insurance Agency immediately with the reason. Also indicate whether the premium is to be returned or credited to your next race date. Once you have started your event, and will not honor ticket delays to the next event, your premium is fully earned.
A check for payment of premium that is returned marked "insufficient funds" will negate coverage and requires further transactions to be paid by either certified check or cashier's check.

Affirmation

AGREEMENTS:

a. Each event shall be conducted in compliance with the most current competition rules of the ISR.

b. Precautions must be taken to restrain unauthorized persons from being on the race course.

c. The promoter must provide adequate barriers, fencing, and other means of crowd control. Ropes and banners are unacceptable.

d. The promoter must display a notice stating "Spectators witnessing these events hereby assume all for injuries or damages resulting therefrom."

e. The promoter shall supply a sufficient number of police/security to maintain crowd control.

The details and data supplied in this enrollment form are warranted to be true and correct and become the equal consideration with the premium paid for which the policy of insurance is issued.

Affirmed

Non-compliance with the underwriting prequirements or misstatements on the enrollment form could void the insurance coverage.
Name of Applicant:
Title:
Signature of Applicant:
Date:

(804) 754-7610 ~ 8002 Discovery Drive, Suite 415, Richmond, VA 23229 ~ ifrazier@frazierinsurance.com

ISR Application

Please note: