Sports Public Liability Quotation

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Submission URL

1. Team/Club Details:

Club/Client name*

Trading name

Company registration number

Activities undertaken*

Are you affiliated to a governing body?*

Please provide details*

2. Contact Details:

Contact name*

Email address*

Website

Mobile phone*

Business phone

3. Address Details:

Club address*

Postal address*

Same as above

1. Background Information:

Insurance refusal*

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*

Risk management*

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

Yes

No

Please provide details*

1. Written policies:

Do you have a written policy for risk management:*

Yes

No

Do you have a written policy for alcohol service:*

Yes

No

Do you have a written policy for blood spillage:*

Yes

No

Do you have a written policy for discrimination:*

Yes

No

1. Current arrangements:

Are you currently insured?*

Yes

No

Please provide details of insurer*

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*

I/we confirm the above statements are true

1. Period of insurance:

Start Date*

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:*

Sports Club/Team Public Liability

Coaching Liability

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

Do you require single or multi-sport cover?*

Single Sport

Multi-Sport

Select your sport*

Please provide details of sports your want to insure*

1. Coverage Type:

Public liability*

Professional indemnity*

Employers liability*

Number of Employees*

Number of Volunteers*

ERN*

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

Wageroll:

Clerical/Managerial*

Coaches/Instructors*

Players/Participants*

Caretakers/Cleaners*

Bar/Catering/Retail*

Ground Staff/Greenskeeper's*

Maintenance/Security*

All others*

2. Risk Information:

a. Number of players/members*

b. Number of non-playing officials*

a. Maximum number of sessions per week*

b. Maximum participants per session*

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

Does your business/club intend to make a profit?*

Yes

No

Club turnover*

If no turnover please enter 0

1. History:

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

Yes

No

Please provide details*

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

Yes

No

Please provide details*

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*

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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