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QUOTE REQUEST - Contact Information |
| Organization Name: |
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| Business Type: |
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First Name: |
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Last Name: |
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Address: |
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City: |
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State: |
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Phone: |
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Zip Code: |
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E-mail: |
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Confirm E-mail: |
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| Website: |
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| Currently
Insured With? |
(or write NONE) |
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What type of coverage are
you seeking? |
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| Do you have any
teams or competitions are your location or do you travel with a team
to compete? |
Please provide details here
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| Do you conduct
background checks on your instructors and employees? |
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Swim Club Section
(if applicable) |
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How many swim instructors do you have: |
Owners:
Employees:
Independent Contractors (1099):
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| How many square feet is your
building (if you rent or own one)? |
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| Do you teach any of these: |
Scuba:
Diving:
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| Who do you teach? |
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| How many of each of the
following do you teach? |
Children (0-14 years old):
Children (15-17 years old):
Adults (18+ years old):
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To qualify
for the Youth Sports programs, you must teach only children 17 and
younger, but we have options if you teach adults too. |
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| Are your swim
instructors all certified? |
Please let us know who certified you or write "NONE" |
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| Do you teach at
a pool that you own? |
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| Do you offer
open swimming to the public? |
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Tennis Insurance Section
(if applicable) |
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| How many tennis
courts do you have? |
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PROPERTY INSURANCE -
OPTIONAL |
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Building Security System? |
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| Business personal property
and equipment? |
$
(tools furniture, computers, etc) |
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| Signs: |
$
(this may include attached or detached signs from
your building) |
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Tenant Improvements
(Renters) |
$
Do you need coverage for the building itself?
Enter the amount
of coverage here. |
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Building Insurance
(Building Owners) |
$
Do you need coverage for the building itself? Enter the amount
of coverage here. |
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| Check other coverages that
you would like: |
Glass
Coverage (Windows)
Business
Income/Extra Expense
ID
Theft
Non-Owner/Hired
Autos
Fences
/ Gates
Mobile
Equipment
Abuse
and Molestation |
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Do you currently
have insurance (if yes, with which carrier)?
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Current Premium:
(this helps us compare rates)
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Complete your request below
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Do you have any other information
about your business, or comments that you would like to
share? Please place special requests here. If you have any special
events or fundraisers planned, please let us know the estimated dates and
the type of event below.
If you teach water polo and swimming, please let us know in
the box below. If you have any PRIOR
CLAIMS please tell us about them here. |
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Someone will contact you about your insurance request to go over the
coverage and options usually in the same day. |
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Swim Club Insurance - Tennis Club
Insurance - Swim School Insurance - Fitness
Studio Insurance - Gym Insurance - Athletic Camp Insurance -
Athletic School Insurance - Cheerleading
Camp Insurance - Day Camp Insurance Camp
- Youth Sports |
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