Performers Details
1. Please provide full details of activities:
2. Do you hold, or have you previously held, Public Liability? —Please choose an option— Yes No
If yes, please provide the name and address of the insurer and the renewal date of the policy.
Name:
3. Which of the following best describes your business.—Please choose an option— Entertainer/Performer Entertainer/Performer (inc Fire) Group Entertainer/Performer Drama/theatre group Entertainment Provider Entertainment/Performance Organiser DJ at any/all locations Entertainment Organiser Santa Santa Grotto Other
If other, please advise.
4. Will you be providing classes? —Please choose an option— Yes No If Yes, please describe the class activities: Does your class activities exceed 1.5m in height? —Please choose an option— Yes No
5. Please advise the number of Entertainers & Performers including you in your performance.
6. Length of cover required. —Please choose an option— 12 months (Annual) 6 weeks 5 days 3 days 2 days 1 day
7. Date you would like cover to be effected from:?
8. Do you have a written Safety Statement/ risk assessment? —Please choose an option— Yes No
9. Are any of the following used by you or any members in connection with your business? *
A. Woodworking or power driven machinery or tools?Yes No Yes No Yes No Yes No Yes No Yes No Yes No
Declaration
10. Please confirm the cover required.
Public Liability —Please choose an option— Yes No
Products Liability – food and drink products only —Please choose an option— Yes No
Non-food Product Liability for other products (available only with Public Liability)
Products Liability is available for other products. Please provide full details so this can be considered.
Employers Liability (not included in cost of Public Liability) —Please choose an option— Yes No
If yes, please state the maximum amount of employees/helpers at any one time. (cover is recommended).
1. Have you ever been convicted/ charged with a criminal offence (excluding motor)? —Please choose an option— Yes No If yes, please provide details.
2. 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? —Please choose an option— Yes No If yes, please provide details.
3. Have you suffered any claim or loss (whether insured or not) in connection with Employers, Public or Products Liability over the last 3 years? —Please choose an option— Yes No 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.
*Please Agree to Proceed
I/we confirm that I/we am/are giving my/our permission for the information we provided in this form to be used for the purposes set out in the Data Protection section https://www.iomst.ie/iomst-privacy-policy .
Please note that the details you are being asked to supply may be used to provide you with information about other products and services from third parties. The fact that you choose not to receive such information will not affect any aspect of the facilities that are provided to you now or in the future.
Please note:
Make sure you tick the, i/we buttons above to submit
