Date of Birth
*
Phone
*
Email Address
*
Address
*
ABN
*
How do you find us?
Please Select
Internet Search Facebook Friends and Family
Insured Name
*
Trading Name
How many years of industry experience does the insured have?
*
Please Select
1 2 3 4 5 6 7 8 9 More than 10
Further explanation on what you do
*
Get a Quote on Liability
*
Martial Arts / Boxing / MMA
When did the business commence trading?
Describe all activities undertaken at the Studio - including details of any weapons use
Number of Instructors
Number of Members / Students
Age range of Members / Students
Will all members be required to sign a disclaimer at each membership renewal?
Please provide us more detail:
Will all casuals be required to sign a disclaimer at each visit?
Please provide us more detail:
Will all the signed disclaimers be safely stored in date order and kept for at least 6 years?
Please provide us more detail:
Are all goods sold or supplied by you and any premises, furnishings, fittings, appliances and plant used by you in a sound condition and comply with all statutory obligations and by-laws or regulations imposed by any public authority for the safety of persons or property?
Please provide us more detail:
Is all your fitness equipment (including components thereof) inspected, serviced and upgraded as per the manufacturers / distributors requirements?
Please provide us more detail:
Are all your gym balls (or swiss / fit balls) checked daily to ensure that they are inflated to the correct level and that they are only in accordance with the manufacturer’s specifications?
Please provide us more detail:
Do you conduct any activities outside the studio premises?
Please provide full details of activities including percentage of your total gross income:
Are there any child minding facilities located inside the studio for which you are responsible?
What are the minimum qualifications your staff must hold?
What is the ratio of supervisors to children?
In the last 10 years, has any application or proposal form for similar insurance made by you been declined, cancellation or had renewal refused or had special terms and / or excesses applied?
Please provide more detail
In the last 10 years, have you been charged with or summoned for; arson, drugs, dishonesty or any kind, malicious damage, theft or injury to another person?
Please provide more detail
In the last 5 years, have any claims for professional negligence or public liability been made against you or any present or former principle, partner or director?
Please provide more detail
Are you, or any principle, partner or director aware of any circumstances that may give rise to a claim?
Please provide more detail
Get a quote on Gym Business
*
Has the insured or any director or partner experienced any claims in the last 5 years?
*
Date of loss
*
Please provide us some detail
*
How much is your incurred amount?
*
Does the Insured use a washing machine or dryer to clean their own clothes, towels on the premises?
*
Has the insured or any director or partner in the past 5 years ever had any previous insurer decline a proposal, refuse to renew a policy or impose special terms or conditions?
*
If you are human, leave this field blank.