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Sports Centres

Your Name:
Your Phone No:
Your Email:
Brokerage Name:
Australian Financial Services Licence No:
Clients Name:
Business Address:
Annual Turnover:
Current Insurer:
Expiry Date:    
Holding Broker:
   
Please advise what sports the insured is involved in and the estimated number of annual participants. If more than one sport please list down individually and specify the members for each sport

 
Sport 
Annual Participants
No of Facilities (ie 3 X Squash Courts)
Coaches/Refs/Officials
1.
2.
3.
4.

Does the Sports Centre offer any of the following activities:

Physiotherapy , Professional Nutritionist, Swimming Pool, Ball sports/Racquet Sports, Rock Climbing, Massage, Beautician,   Equipment Hire

 Yes NO

Please select the property cover you require:
Fire Yes NO

Please supply the following information about the premises:

Construction:

Security:

Deadlocks    Bars on Windows    Local Alarm        Monitored Alarm
Fire Prevention: Extinguishers Smoke Detectors Monitored Smoke Detectors Sprinkler System
Is cooking carried out on the premises? Yes No                             If Yes is a Deep Fryer Used : Yes  No

Sums Insured

Building:

Contents including Stock
Other: 


Business Interruption Yes NO


Burglary Yes NO


Money Yes NO


Glass Yes NO


Broadform Liability / Errors & Omissions Extension Yes NO


Machinery Breakdown Yes NO


Electronic Equipment Yes NO


General Property Yes NO


Has the insured had any claims in the past 5 years that would be covered by the proposed insurance?   Yes NO


Is there any other information you would like to provide? Yes NO

 

Your Name:      
Date:     
Please press the submit button. A response will be sent to your nominated email address.

 

 
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