NOTICE TO THE APPLICANT

No fact, circumstance or situation indicating the probability of a Claim or action for which coverage may be afforded by the proposed insurance is now known by any person(s) or organization(s) proposed for this insurance other than that which is disclosed in this application. It is agreed by all concerned that if there is knowledge of any such fact, circumstance or situation, any Claim subsequently emanating there from shall be excluded from coverage under the proposed insurance.

For the purpose of this application, I declare that to the best of my knowledge and belief, after reasonable inquiry, the statements in this application and in any attachments, are true and complete. Underwriting Managers or the Company are authorized to make any inquiry in connection with this application. Signing this application does not bind the Company to provide or the Applicant to purchase the insurance.

If the information in this application and any attachment materially changes between the date this application is signed and the effective date of the policy, I will promptly notify the underwriter, who may modify or withdraw any outstanding quotation or agreement to bind coverage.

INSURANCE FRAUD WARNING

Any person who knowingly and with intent to defraud any insurance company or another person files an application for insurance or statement of claim containing any materially false information, or conceals for the purpose of misleading information concerning any fact material thereto, commits a fraudulent insurance act, which is a crime in certain jurisdictions, and subjects the person to criminal and civil penalties.

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Please review SAMPLE POLICY here

TERMS AND CONDITIONS

A. I warrant to the Company, that I understand and accept the notice stated above and that the information contained herein is true and that it shall be the basis of the policy and deemed incorporated therein, should the Company evidence its acceptance of this application by issuance of a policy.

B. I confirm that I understand that this policy excludes coverage for: any Person while Practicing for or Participating in a Demonstration, Show, Competition, Contest or Athletic Event; Animal Exposures; (classified animal event removes animal exclusion) Assault & Battery; Auto Exposures; Communicable Diseases; Cyber Acts, Incidents or Data Breaches; Explosives; Firearms; Unmanned Aircraft

C. I confirm that there will be no Mosh Pits or Fireworks/Pyrotechnics, unless by a licensed/insured vendor. Sparklers OK

D. I understand there is no coverage for water activities, amusement devices, inflatables, rides or animals (classified animal event removes animal exclusion). This does not mean I cannot have them at my event, it means this policy will exclude coverage for water activities, amusement devices, inflatables, rides or animals. This policy will not cover any athletic or sports participants, employees, volunteers, or individuals compensated by the insured.

E. I understand that the event types under "EXCLUDED EVENT TYPES" are excluded from this policy.

EXCLUDED EVENT TYPES & ACTIVITIES

Aircraft Events; Boat Shows (on the open water); Cannabis Events or Products; Childcare; Concerts with Rap, Hip Hop, Heavy Metal, or Hard Rock; Firework/Pyrotechnics (Sparklers OK); Events with fire performers; Fraternity Events; Go Kart Races; Hang Gliding/SkyDiving; Haunted Attractions; Haunted Houses; Hot Air Balloon Rides or Events; Motorized Sporting Events; Music Events with Overnight Exposure; Obstacle Races and Mud Runs; Parachuting; Parasailing; Political or Activist Events including Protests, Rallies or Marches; Raves; Roller Coasters/Sky Coasters; Roller Derby; Roller Skating Events; SkyDiving; Skateboarding; Sorority Events; Tractor Pulls; Trampolines; Unmanned Aircraft; Wall Climbing; War Games/Re-enactments; Water Events (unless classified as water event type); Water Slides; Weapon Events including Gun Shows

F. I am hereby notified that my policy will terminate effective no later than the date and time of its expiration. I have no right of automatic renewal and additional coverage will require application with no guarantee of approval or policy issuance.

I understand that by purchasing this insurance I am joining the Promotion, Event and Prize Purchasing Group.

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Licensed Agent in all 50 states: Will Maddux