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Section 2: GENERAL INFORMATION
INSURANCE AND PROPERTY INFORMATION
Current Insurance Carrier:
Any incidents or claims whether reported or not in the last 5 years?
If yes, please explain:
Any policy declined, canceled or non-renewed within the past 3 years?
Are you within city limits?
Do you own or lease your property?
Additional Insured Name:
Section 2B: ESTIMATED PLAYERS AND ANNUAL RECEIPTS
Estimated Number of Annual Participants:
Estimated Annual Gross Receipts from Admissions, Rentals, & BB's:
Estimated Annual Gross Receipts from on site Pro Shop (upgrades, gloves, etc):
Estimated Annual Gross Receipts from concessions* (food, drinks, etc):
*unless contracted out and contractor carries their own insurance
Estimated Total Annual Gross Receipts:
Please make sure that you have completed everything to the best of your knowledge before going to the next page.