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CONTACT DETAILS
Contact Name*
Company Name
Telephone Number*
Email Address*
Business Address
Town
Postcode*
Location of Premises*
—Please choose an option—Business Park UnitIndustrial UnitUnit Within Indoor shopping CentreSelf Contained Premises Within Multi Tenure MillResidential StreetsideHigh StreetIndoor leisure complex
Type of Trade*
—Please choose an option—Children’s Indoor Soft Play & Party Centre with CafeteriaChildren’s Indoor Soft Play & Party Centre without CafeteriaChildren's Indoor Play Cafe with Play FrameChildren's Indoor Play Cafe without Play FrameChildren's Indoor Role Play Centre with CafeteriaChildren's Indoor Role Play Centre without CafeteriaMobile Soft Play Hire excluding InflatablesMobile Soft Play Hire including InflatablesOther (Please detail below)
Trading Status*
—Please choose an option—Limited CompanyPartnershipSole Trader Trading as
Website
Number of Years Trading
Policy Due Date
Current Insurance Held With
Current Insurance Premium
Have You Had Any Claims in the Last 5 Years?*
—Please choose an option—YESNO
If Yes, Please Detail Dates, Incidents, and Amounts
Are You a Member of the Association of Indoor Play (AIP)?*
FACILITIES AVAILABLE
Select all that apply
Soft Play Equipment / Soft Play FrameSports ArenaPlay 'Town' / Role Play For ChildrenCraft ActivitiesBall PoolsFace PaintingHair, beauty or cosmetic treatmentsBouncy Castle or other Inflatable Play EquipmentTrampolines (Standalone)Trampoline within Play FramePaddling/Swimming PoolsLicensed BarPedal Kart TrackNon-Motorised Ride On Toys (e.g Little Tikes)Self Propelled Ride on Karts or SimilarVending/Gaming/Amusement MachinesMechanically or electrically powered ridesFoam dart or nerf warsLaser TagClimbing WallTraverse WallOutdoor Play AreaPetting FarmZip Wire / Aerial Runway / Rope CourseRoller skating or bladingBowling LanesNurserySupervised CrecheSupervised Drop and PlayAfter School ClubYouth ClubSports ActivitiesPrivate Hire for Children's PartiesPrivate Hire for Adult PartiesPremises used by 3rd parties (e.g toddler groups, dance, baby classes)Other
Maximum Age of Children on Play Frame*
—Please choose an option—3456789101112131415+
Maximum Capacity of Children in Premises
Is Frying Equipment Used?*
SUMS INSURED (BEST ESTIMATES IF NEW BUSINESS)
Buildings
Subsidence Cover Required?*
Tenants Improvements
Electronic Business Equipment
All Activity & Play Equipment
Other Contents, Fixtures and Fittings
All Other Stock
Wines & Spirits
Beers
Frozen or Refrigerated Stock
Glass
Signs & Canopies
Money (during Business Hours)
Money (after Business Hours in Safe)
Type of Safe*
—Please choose an option—No Safe on PremisesSafe Installed in Line with Manufacturer Rating
Goods in Transit
Business Interruption Cover Required
Business Interruption Indemnity Period*
—Please choose an option—12 Months18 Months24 Months36 Months
Loss of Rental Income
Outstanding Debit Balances (Book Debts)
Loss of Licence
Public Liability Indemnity Limit*
—Please choose an option—£1,000,000£2,000,000£5,000,000£10,000,000
Annual Turnover
Number of Employees
Annual Staff Wageroll
Employers Reference Number (ERN)
Do the Premises Have an Intruder Alarm?
—Please choose an option—NOYES - Bells / Audible OnlyYES - Digital CommunicatorYES - Central Station
Does Your Alarm Have Police Response?
—Please choose an option—NOYESNot applicable
Do the Premises Have CCTV?
Do the Premises Have a Fire Alarm?
What Year Were the Premises Built?
—Please choose an option—Pre 18511851 - 19201921 - 19391940 - 19791980 - 19891990 - 19992000 & later
Notes
DECLARATION
You or any director or partner in any business, any partner in any partnership, any director of any company, or the company; either in any personal capacity, in the name of the business proposed or in respect of any other business in which any of you have ever had an interest have:
- Never had a proposal for insurance declined, cancelled or refused? - Never had insurance cancelled mid-term, a renewal refused, increased or special terms or conditions imposed by an insurer? - Never been given an official police caution, convicted of, charged (but not yet tried) or have any prosecution pending for any offence (excluding any motoring convictions and any offences which are spent under the Rehabilitation of Offenders Act 1974)? - Never been the subject of or issued with a County Court Judgement (CCJ), money judgement or court decree and/or ever been cited in any unsatisfied court judgements (or the Scottish equivalent) or any other judgements or decrees in relation to debt? - Never been declared bankrupt or insolvent, the subject of an individual voluntary arrangement (IVA) or company voluntary arrangement (CVA) with creditors, voluntary liquidation, a winding up or administration order, or administrative receivership proceedings, bankruptcy or insolvency proceedings? - Never been disqualified from being a company director? - Never been censured by any regulatory or trade body or any action been taken against the company by the office of fair trading, consumer groups or the alike? - Never been served under any Health & Safety, Welfare, Environmental, Consumer Protection or Food Safety legislation or any other legislation, with any warnings, enforcement measures, prohibition notice, improvement orders, proceedings or criminal proceedings by any Health and Safety Executive, Environmental Health Office, Environment Agency, local or government authority or any other enforcement agency or authority? - Never been convicted of, charged (but not yet tried) with, officially cautioned or have any prosecution pending for a breach of any Health & Safety, Welfare, Environmental, Consumer Protection, Food Safety legislation or any other legislation? - Never been the subject of a recovery action by Customs and Excise or the Inland Revenue?
Please confirm if you agree with the declaration*
—Please choose an option—NO - I Do Not AgreeYES - I Agree
If you do not agree — please explain
How did you hear about us?
—Please choose an option—AI OverviewChatGPTClaudeGeminiCoPilotMetaGoogle Web SearchGoogle Sponsored ResultGoogle AdYahoo Web SearchBing Web SearchOther Web SearchFacebookTwitterLinked InPlay Industry ForumAssociation of Indoor Play (AIP)RecommendationExisting ClientWord Of MouthAdvertisementOther
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