CERTIFIED PERSONAL TRAINERS - INFOFIT
PROFESSIONAL LIABILITY AND COMMERCIAL GENERAL LIABILITY INSURANCE
APPLICATION

Note: This insurance program provides coverage for personal trainers who reside and work in Canada. If you require coverage for training services provided outside of Canada, contact Sonja Aracena at:

Metrix Professional Insurance Brokers Inc.
400-555 Burrard Street
Vancouver, BC V7X 1M8
Direct Line:(604) 629-2671
Toll Free: 1-800-690-7475 Fax: (604) 683-8032
E-mail: saracena@mpib.com

THIS APPLICATION IS FOR PROFESSIONAL LIABILITY COVERAGE WRITTEN ON A CLAIMS MADE AND REPORTED BASIS, WITH DEFENSE COSTS INCLUDED IN THE LIMIT OF LIABILITY. ALL QUESTIONS MUST BE ANSWERED.

Name of Applicant *
Your answer
Address *
Please provide full address including postal code
Your answer
Telephone and area code *
Your answer
Email address *
Your answer
Did you obtain your personal trainer certification from Infofit? *
If yes, confirm the date certification was obtained.
MM
/
DD
/
YYYY
Do you hold Personal Trainer Certification from other fitness organizations? *
If yes confirm the name of each organization, type of training/certificate and the date certification was obtained
Your answer
Are your personal training services (select all that apply) *
Required
If you provide online personal training services:
Have you taken necessary educational courses and are you qualified to do so?
What percentage of your clients reside outside of Canada?
Indicate percentage if applicable
Your answer
Do you rent/lease any commercial space for the provision of personal training services? *
If yes an additional premium will be charged, this does not include drop in sessions to public or private facilities
Do you own or operate a facility, studio or clinic? *
If so, we will contact you to complete an alternate application as there is no coverage under this insurance program if you own or operate a facility, studio or clinic.
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