Dancecover Platinum Liability Application Form
Please complete the following questions and then click "Submit". We will then forward our quotation documentation to you for your consideration. If further information is required, we will contact you prior to forwarding our quotation.
First Name :
Your answer
Surname :
Your answer
Business Name :
Your answer
Postal Address :
Your answer
Contact Number :
Your answer
Email Address :
Your answer
Business Description :
Your answer
Estimated Gross Annual Turnover / Income :
Your answer
Number of Students / Members :
Your answer
Number of Teachers (Principals / Employees / Contractors) :
Your answer
Style of Dance & Performing Arts :
Your answer
Do you require Aerial cover ?
Will you be running any Public Events ? If yes, please advise details of Events & expected attendance numbers.
Your answer
Do you currently hold Public Liability / Professional Indemnity cover ? If yes, please advise Insurer and date cover is due.
Your answer
Limit of Public Liability required :
Do you require Management Liability ?
Have you had any claims in the last 5 years ?
Please subscribe me to the "Dance Teachers In the Know" monthly newsletter ?
How did you hear about us ?
Your answer
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