Sports Public Liability Quotation

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Submission URL

1. Team/Club Details:

Club/Client name(Required)

Trading name

Company registration number

Activities undertaken(Required)

Are you affiliated to a governing body?(Required)

Please provide details(Required)

2. Contact Details:

Contact name(Required)

Email address(Required)

Website

Mobile phone(Required)

Business phone

3. Address Details:

Club address(Required)

Postal address(Required)

Same as above

1. Background Information:

Insurance refusal(Required)

Has any insurer ever declined, refused to renew or has imposed special terms and conditions to any insurance policy/renewal or application for insurance held or made by the club?

Yes

No

Please provide details(Required)

Risk management(Required)

Has any member of your Club completed a Risk Management course?

Yes

No

Please provide details(Required)

1. Written policies:

Do you have a written policy for risk management:(Required)

Yes

No

Do you have a written policy for alcohol service:(Required)

Yes

No

Do you have a written policy for blood spillage:(Required)

Yes

No

Do you have a written policy for discrimination:(Required)

Yes

No

1. Current arrangements:

Are you currently insured?(Required)

Yes

No

Please provide details of insurer(Required)

2. Your/directors status:

a) I/we have not had an insurance proposal declined, cancelled or refused;
b) I/we have not had any renewal refused;
c) I/we have not had any special terms or conditions imposed;
d) I/we have not been convicted or charged (but not tried) or been given an Office Policy Caution, in respect of any criminal offence;
e) I/we have not been the subject of any County Court Judgement or Sheriff Court Decrees;
f) I/we have not been declared bankrupt or insolvent or been disqualified from being a company director or been involved as owner Director or partner with any company which went into receivership, administration or liquidation;
g) I/we have been a UK resident for the past 12 months.

Please confirm that the above statements are all true(Required)

I/we confirm the above statements are true

1. Period of insurance:

Start Date(Required)

The start date must either be today or a date in the future (within 30 days). All policies run for 12 calendar months.

2. Insurance Type:

Select your requirements:(Required)

Sports Club/Team Public Liability

Coaching Liability

3. Select the sports/activities that your client undertakes:

Do you require single or multi-sport cover?(Required)

Single Sport

Multi-Sport

Select your sport(Required)

Please provide details of sports your want to insure(Required)

1. Coverage Type:

Public liability(Required)

Professional indemnity(Required)

Employers liability(Required)

Number of Employees(Required)

Number of Volunteers(Required)

ERN(Required)

What is an Employers Reference Number (ERN)? Click here for more information.

Wageroll:

Clerical/Managerial(Required)

Coaches/Instructors(Required)

Players/Participants(Required)

Caretakers/Cleaners(Required)

Bar/Catering/Retail(Required)

Ground Staff/Greenskeeper's(Required)

Maintenance/Security(Required)

All others(Required)

2. Risk Information:

a. Number of players/members(Required)

b. Number of non-playing officials(Required)

a. Maximum number of sessions per week(Required)

b. Maximum participants per session(Required)

c. Maximum length of sessions (hours & minutes)(Required)

Club turnover(Required)

Please tell us your total turnover, this should include the past 12 months income you have received as a club. If you have zero income please enter 0

1. History:

1. Have any claims been made by you or associated directors in the past five (5) years?(Required)

Yes

No

Please provide details(Required)

2. Have there been any incidents in the past five (5) years that may result in claims against you or associated directors?(Required)

Yes

No

Please provide details(Required)

1. Submit to underwriting:

I/we declare that all the submitted information with this online proposal form is true and accurate at the time of submission.

I/we also accept that underwriters may seek further information based on the information I/we have submitted and will assist to allow the underwriters to accurately assess the risk.

Please confirm that you have read and understood the above statements(Required)

I/we understand

Sports Public Liability Quotation

PROPOSAL FORM

1. Team/Club Details:

2. Contact Details:

3. Address Details:

1. Background Information:

1. Written policies:

1. Current arrangements:

2. Your/directors status:

1. Period of insurance:

2. Insurance Type:

3. Select the sports/activities that your client undertakes:

1. Coverage Type:

Wageroll:

2. Risk Information:

1. History:

1. Submit to underwriting:

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