Group Dog Club Insurance Program (Associations of Dog Clubs)

Name of Club :
Contact Person :
Street Address :
Email Address :
Phone Number :
Number of Members :
Current Insurer : (If applies)
Date of Current Policy expires?
Any Equipment to be Insured?
Please list Items and Replacement Cost:

Activities/Events to be held by club :
Losses in the past 5 years?
(Check if yes )
If so, what type - Liability or property?
Does club train for remuneration?
 (Check if yes)
If so what are the approximate annual receipts?