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.

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First Name : *
Surname : *
Business Name : *
Location Address including Postcode *
Contact Number : *
Email Address : *
Business Description : *
Gross Annual Turnover (total income your business generates - wages/expenses should not be deducted) *
Number of Students / Members : *
Style of Dance & Performing Arts : *
Do you require cover for Aerial activities (i.e. silks, hoops, lyra etc)? If yes, is the apparatus fixed & installed/maintained by a certified rigger? *
Do any activities involve trampolining or foam pit activities? *
Will you be hosting any Public Event/s?  If yes, please provide details of the event/s & expected daily attendance numbers (performers & audience)
Do you currently hold Public Liability / Professional Indemnity cover ?  If yes, please advise Insurer and date cover is due. *
Limit of Public Liability required : *
Do you require Management Liability ? *
Have you had any claims in the last 5 years ? *
How did you hear about us ? *
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