SPORTS LIABILITY APPLICATION

Our Sports Application provides both Spectator & Participant General Liability and Excess Accident Medical for many types of events. Please note that we can also offer Excess General Liability and Non Owned/Hired Automobile coverage, if so desired. If there are any questions about Excess Accident Medical or Participant General Liability please refer back to the Insurance 101 section of the website for more information.

Section
NAME AND ADDRESS
NAME AND ADDRESS
NAME AND ADDRESS
LIABILITY INFORMATION
DESIRED EFFECTIVE DATE
DESIRED EFFECTIVE DATE
DESIRED TERMINATION DATE
DESIRED TERMINATION DATE
Checkbox
Please note that our standard limits of liability are $1,000,000 occurrence and $2,000,000 aggregate. Most venues/cities/locations require this minimal amount of coverage. We do not offer policies less than $1,000,000.
We have the ability to raise our limits of liability over $1,000,000 occurrence—some venues/cities/locations require this. Selecting Excess General Liability is not advised unless a venue/city/location is requesting higher limits as this will increase the total premium. If you have questions about this, please contact our office.
REQUIRE NON-OWNED / HIRED AUTO COVERAGE?
REQUIRE ABUSE / MOLESTATION COVERAGE?
HAS ANY INSURANCE CARRIER CANCELLED OR REFUSED COVERAGE?
EVENT INFORMATION
Please note that different types of sports or activities use different rates, so this information is vital for underwriting. Also, if your event is a camp or planned activity using multiple sports, please let us know all types which will occur.
Number of estimated participants is very important for rating—we base a large portion of our premium on the number of participants. If you do not know exact numbers, using a range of participants will still be helpful for rating.
EMERGENCY EVACUATION PLAN IN PLACE?
QUALIFIED MEDICAL PERSONNEL IN ATTENDANCE
AMBULANCE SERVICE IN ATTENDANCE?
LIQUOR LIABILITY
WILL ALCOHOLIC BEVERAGES BE SOLD?
IS APPLICANT RESPONSIBLE FOR THE SALE OF THE ALCOHOL?
WILL THERE BE BYOB (BRING YOUR OWN BOTTLE)?
WILL CONCESSIONS PROVIDE YOU WITH CERTIFICATES EVIDENCING PRODUCTS LIABILITY WITH YOUR ORGANIZATION NAMED AS ADDITIONAL INSURED?
AFFIRMATION AND SIGNATURE
I hereby warrant and confirm that the above information, to the best of my knowledge, is true and correct, and further certify that I have read all of the questions and answers on this application. I understand this application is a requirement for coverage, a part of the contract and evidence of my acceptance of this insurance, and any falsification or misrepresentation will be deemed a breach of contract, voiding all insurance coverage. It is understood and agreed that the completion of this application shall not be binding either to the proposed insured or the company until accepted by the company or companies in writing. *
BROKER INFORMATION