liability insurance

Sportscover Public & General Liability/Professional Indemnity Insurance Quote Request

We have tried to make the quote request input as simple as possible. When entering numbers, please do not use spaces, a currency sign, %, comma, hyphens or decimal places. Always enter whole numbers only.

Asterisk (*) denotes compulsory input field.

	Sportscover Public & General Liability/Professional Indemnity Insurance
	*Contact Name:
	*Organisation Name:
	*Postal Address:
	*Suburb/Town:
	*Postcode/Zipcode::
	*State/County/Province:
	*Country:
	Phone no:
	Fax no:
	Email Address:
	*Sport:
	*Period of Insurance:
	Activities Undertaken by the Club, ie the Sport:
	Is the Club Incorporated:	Yes No
	Does the Club/Association Own the Above Premises:	Yes No
	Hire out those Premises:	Yes No
	Own the Equipment Used:	Yes No
	Hire out the Equipment:	Yes No
	Operate Licensed Premises:	Yes No
	Sell Goods to the Public:	Yes No
	Is there a Grandstand:	Yes No
	Host International Events:	Yes No
	If you answered YES to any of the above, please provide full details:
	Has the Club/Association entered into any contractual agreements:	Yes No
	If YES, Please provide full details:
	Number of Events/Meetings/Games per year:
	Number of Spectators at each Event/Meeting/Game (Average):
	Approximate duration of season:
	Number of Committee Members and Officials:
	Number of Registered Non-Playing Members:
	*Number of Registered Players/Members/Teams to be covered and which type of Liability required:
	Current Insurer:
	*Have you had any claims in the past 3 years?	No Yes
	If you clicked "YES" in the previous question, please give details of claims:
	Any other Relevant Information:
	*Name of Agent requesting Quote:
	or