Sports Application – Insurevents

Sports Liability & Medical Package Application

Step 1 of 5

Policyholder Information
Please, do not type in ALL CAPS anywhere on this form.
Your Company Name
The company name on the policy should be the same legal entity signing the rental agreement, contract, or permit, if any. This is NOT the place to put the event location or event name. You will be asked for that information later. Insurance Brokers- DO NOT put your name here. You will be asked for that information on the next screen.

The company name on the policy should be the same legal entity signing the permit/rental contract, if any.
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This is NOT the place to put the event name. You will be asked for that information on the next screen.
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Insurance Brokers- DO NOT put your name here. You will be asked for that information on the next screen.
Your Full Name*
Address*
Street Address City State ZIP Code
Primary Phone Number (Preferably Mobile)*
DO NOT place a 1 in front of your telephone number.
Can this phone accept texts?
- Yes
- No
Click Yes if you would like reminder texts about your quote & policy.
Email (If you are an insurance broker, use your email & not your clients)*
Enter Email Confirm Email
Hidden
obsolete 8-20-19
Website
How many years of experience do you have?*
Who referred you to us?
Are you a Non-Profit Corporation?
- Yes
- No
Are you an insurance agent/broker applying for a quote on behalf of your client?*
- Yes
- No
For Insurance Agents & Brokers Only
Your Insurance Agency Name

Remember to enter YOUR email address above, NOT your client's email. Otherwise they will receive automatic notifications and our quote instead of you.
Agents First Name
Agents Last Name
Address
Mailing Address City State / Province / Region ZIP / Postal Code Country
Telephone
DO NOT place a 1 in front of your telephone number.
Remember to enter your email address on the previous screen in lieu of your client's email.

Or, Save what You've Entered So Far and Continue Later

Venue/Site Information
Name of Venue*
Venue Contact's First & Last name*
Venue Contact's Email
Venue Telephone
Venue Fax
Address*
Mailing Address City State / Province / Region ZIP / Postal Code Country
Venue's additional insured wording (found in your rental agreement)
You can upload a copy of your permit/rental agreement below.
Does the contract require a Primary & Noncontributory endorsement?*
Higher rates apply if you need it.
- Yes
- No
Does the contract require a Waiver of Subrogation endorsement?*
Higher rates apply if you need it.
- Yes
- No
What Per Occurrence limit does the venue require (found in your rental agreement)*
What Aggregate limit does the venue require (found in your rental agreement)*
Who is supplying security*
Is security armed?*
- Yes
- No
Type of Security (Uniform, peer group, ushers, etc.)*
How many of each*
Type of seating (folding, bleachers, standing, / reserved, general admission*
Upload a copy of your permit/rental contract
OPTIONAL but will tell us pretty much everything we need to know on how to structure your policy. Acceptable file types: pdf, jpg, gif, png, doc, docx, xls, xlsx. Maximum File Size: 128MB.
Drop files here or

Accepted file types: pdf, jpg, gif, png, doc, docx, xls, xlsx, Max. file size: 256 MB.
Provide details (including addresses) of all of your other locations*

Or, Save what You've Entered So Far and Continue Later

Resources

Client Services

Resources

Client Services

Sports Liability & Medical Package Application

Step 1 of 5

Policyholder Information

For Insurance Agents & Brokers Only

Event Details

Venue/Site Information

Additional Event Details

Options That Can Be Added To your Policy

Support

Client Services

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