Event Organiser / Operator

Personal Details

Name in Full:
*

Trading Name:

Company Name:
(fill this box in only, if you have a LTD Company)

Address:
*

Phone/Mobile:
*

Date of Birth:
*

Email:
*

Photo ID:

In order to get your membership/insurance card you need to attach a photo of (yourself) the insured member, the image should be similar to the sample image above.(Please note: If the photo size is to big the form will not send. Please resize or attach in a separate e-mail).

Organisers/Operators Only

Please provide your projected turnover per annum.

1. Please advise the number of events organised by you.(per year):

2. Please advise the number of traders and or 3rd party participants.

3. Please advise the Maximum attendance at any one time (customers).

4. Please list the name(s) events organised by you.

5. Please provide the list of activities taking place (please list all actvities).

6. Please provide the Date/ Duration of the Event(s).

7. Please provide the Event(s) Location(s).

Details

1. Please advise the type of events.

2. Do you hold, or have you previously held, Public Liability?
---YesNo *
If yes, please give the name and address of the insurer and the renewal date of the policy.

3(a). Do you require an Event Licence?
---YesNo *
If YES, has one been granted?.

3(b). Have the police been notified?
---YesNo *

3(c). Have the Fire Authorities been notified?
---YesNo *

3(d). Have provisions for First Aid been made?
---YesNo *

3(e). Please advise the number of Stewards provided.
*

3(f). Have you prepared a Safety Statement?.
---YesNo *

Safety Statement- Required[

.

3(g). Have you appointed a Market/event Safety Officer?
---YesNo *

3(h). Do you provide camping or car parking facilities?
---YesNo *

If yes, please give details.

3(i). Do you use a professional security company to provide crowd control, stewarding/security?
---YesNo *

If yes, please give details.

Amusements & Attractions

4(a). Is there a funfair forming part of your event?
---YesNo *

If yes, please note that the funfair is not covered by this insurance so you must obtain from the funfair’s operators an insurance certificate and engineers report for each ride/attraction.

4(b). Is there a fireworks display forming part of your event? ---YesNo *

If Yes, please attach a copy of their insurance certificate.

4(c). Are there any bouncy castles or other inflatables forming part of your event?
---YesNo *

If yes, please attach a copy of their insurance certificate.

Cover Required

5. Please confirm the cover required.

Public Liability ---YesNo

Employers Liability (not included in cost of Public Liability) ---YesNo

If yes, state maximum amount of employees/helpers (cover is recommended)

Products Liability - Applies to food and drink products only ---YesNo

(available only with Public Liability) N.B. In respect of food units please provide a photograph with your proposal.

Products Liability is available for other products. Please provide full details so this can be considered.

6. Have you ever been convicted/ charged with a criminal offence (excluding motor)?
---YesNo *
If yes, please provide details.

7. Has any insurer ever declined a proposal, cancelled or refused renewal or required special terms on any of the insurances for which you are now proposing?
---YesNo *
If yes, please provide details.

8. Have you suffered any claim or loss (whether insured or not) in connection with Employers, Public or Products Liability over the last 3 years?
---YesNo *
If yes, please provide details.

• Our limit of indemnity for Employers Liability is € 13,000,000.
• Our limit of indemnity for Public or Products Liability is € 13,000,000.
• Products Liability €13,000,000 automatically applies to food and drink. Other products can be included where agreed by insurers.