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Alternatively we can collect details over the phone with you.


Play FrameSports ArenaCraft ActivitiesBall PoolsFace Painting By Own StaffBouncy CastleTrampolines (Standalone)Trampoline within Play FramePaddling/Swimming PoolsLicensed BarDesignated Dance FloorPedal Kart TrackNon-Motorised Ride On Toys (e.g Little Tykes)Self Propelled Ride on Karts or Similar TrackVending/Gaming/Amusement MachinesLaser TagClimbing WallOutdoor Play AreaPetting FarmZip Wire (Standalone)Roller DiscoBowling LanesNurserySupervised CrecheSupervised Drop and PlayAfter School ClubYouth ClubSports ActivtiesPrivate Hire for Adult PartiesOther

Sums Insured - If a new venture, please provide your best estimates

Declaration
1) Previous Insurance - For previous insurances have you or any director or partner to be insured had;
a) Any proposal or insurance declined, cancelled or refused? - No
b) Any renewal refused? - No
c) Any special terms or conditions imposed? - No
d) Any insurance cancelled mid-term by underwriters? - No

2) Financial Statement - Have you or any director or partner in the business or person to be insured;
a) Been convicted of or charged (but not yet tried) or been given an official police caution in respect of any criminal offence other than a motoring? - No
b) Either personally or in any business capacity been declared bankrupt, insolvent or gone into liquidation or been subject to any bankruptcy or insolvency proceedings? - No
c) Been a director or partner in any business 6 months prior to or at the time of and/or after the appointment of a receiver or liquidator or dissolution through insolvency? - No
d) Ever been the subject of a County Court Judgement, an Individual Voluntary Arrangement, a Company Voluntary Arrangement or a Sheriff Court Decree? - No
e) Been disqualified from being a company director? - No
f) Been prosecuted or have prosecutions pending under the Health & Safety at Work Act or any other statute or regulation? - No
g] Ever been censured by any Regulatory or trade body or any action taken against the company by the office of fair trading, consumer groups or the alike? - No

3) Material facts - Please note that failure to disclose all material facts (that is those facts an insurer would regard likely to influence the acceptance or assessment of an insurance risk) may invalidate the Insurance. If you are in any doubt whether a fact is material you should disclose it. You are advised to keep a record (including copies of letters) of all information supplied to the Insurer for the purpose of entering into the contract of Insurance. Are you aware of any matter, fact, circumstance or incident existing or threatened that could possibly affect the Risk(s) to be insured which might result in a loss under this insurance - No