No Obligation Professional/General Liability Quote for Instructors & Trainers
Complete this online form TODAY for an immediate quote!
(click here for a printable version)

All required fields in this form are indicated with a red asterisk: *

*First Name:

*Last Name:

Mailing Address:

*Street:

*City:

*State: *Zip Code:

*Phone:

Fax:

*Email:

*Association Membership: Yes No
If Yes, please indicate which one:

*Average per month the number of students and/or horses you instruct:

*Activities you are involved in:

Judge
Group Instructor
Course Designer
Clinician
Trainer

Therapeutic
Steward
Show Official/Mgr
Technical Delegate
Prof. Rider/Driver

*Gross Annual Receipts for activities listed above:

*Are you involved in boarding/breeding? Yes No
If Yes, how many horses?:

*Are you involved in any horse sales, day camps, trail rides, pony rides or sleigh rides? Yes No

*Do you have a primary farm/ranch policy? Yes No

*Do you currently have a policy that covers any of the above equine related exposures? Yes No

*Do you have any assistants or partners? Yes No
If Yes, how many?:

*When would you like for coverage to begin? (please note that only future dates can be considered)

*Check if you are certified by one of the following:
ARIA
CHA

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* Please tell us how you heard about us.

Other/Please Specify:


 All coverages are subject to policy limits, conditions and exclusions.