Request a Quote for Running Race Insurance

Running Race Insurance Form

Name of Organization (you)

Contact Name

Contact Mailing Address

Street Address

City

State

Zip Code

Contact Phone Number

Contact Email

Event Website/Social Media Page

Start Date

End Date

Number of Estimated Participants

Race Name

Race Starting Point Address

Please Describe the Race Terrain

Race Distance

Please confirm the course is checked for potholes/other defects and marked accordingly prior to race.

Yes

Is liquor liability required? (Please note, if you are not in the business of serving, selling or distributing liquor and will not receive any revenue from the sales of liquor, liquor coverage is not required.)

Yes

Have you held this event before?

Yes

Will all participants sign waivers?

Yes

Please confirm you have no insurance claims, losses or cancellations within the past 3 years.

I confirm no claims/losses/cancellations within the past 3 years.

I have a claim/loss/cancellation within the past 3 years.

Declaration For Submitting

To the best of my knowledge and belief the information provided in this application, whether in my own hand or not, is true and I have not withheld any material facts. I understand that Non-disclosure or misrepresentation of a material fact will entitle the company to void the Insurance. I understand that submitting this Application does not bind me to complete the insurance but agree that should an insurance policy be issued, this Application and the statements made therein shall form basis of the insurance policy. I understand the activities listed in the list of planned activities box above are the only activities covered under this policy.

(By clicking “submit” below you are agreeing to the following statement)

Request a Quote for Running/Road Races

Declaration For Submitting