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1Contact & Event Information
2Insurance Information
3Additional Insured & Digital Signature
  • Policyholder Information

  • The name of the business/organization purchasing the insurance; as it will appear on the policy documents and/or other contract or rental agreements.
  • Event Details

  • Desired coverage date (including setup and tear down):
  • MM slash DD slash YYYY
  • to
  • MM slash DD slash YYYY
  • Please provide a detailed list of all activities to be held or what will take place for the duration of your event to ensure your event is quoted properly and returned promptly.
  • Insurance Details

  • List the sport(s) to be covered at the event.
  • 18 and under.
    Please enter a number less than or equal to 1000.
  • 19 and up.
    Please enter a number less than or equal to 1000.
  • Please enter a number less than or equal to 300.
  • Please enter a number less than or equal to 1000.
  • If yes, a full list of the obstacles will be required before a quote will be released. Please upload description of obstacles here or email to: Caitlyn@AnthonyInsuranceServices.com
  • Click here if you need a copy of a waiver.
  • If you do not yet have such a plan in place, please click here for our Guide to Risk Management.
  • A minimum accident limit of $10,000 is required if participant liability coverage is desired.
  • Additional Insured

  • Additional Information & Digital Signature

  • Any person who knowingly presents a false or fraudulent claim for payment of a loss or benefit or knowingly provides false information in an application for insurance may be guilty of a crime and may be subject to civil fines and criminal penalties. I certify that the above information is true and coverage is not in force until accepted by Anthony Insurance Services, Inc. Coverage is subject to the receipt of payment of the required premium by Anthony Insurance Services, Inc.

    Coverage will begin on the date of acceptance or on the date requested, whichever is later. I understand that the premium is fully earned upon policy inception.
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Anthony Insurance Services

Toll Free: (877) 811-2271
Fax: (720) 836-6399

For dance, yoga, gymnastics, or fitness insurance, see our sister website Dance Studio Insurance.

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