All fields marked (*) are required.

Are you an insurance agent or broker? *
Address
If not applicable, leave blank
Association Membership *
If yes, please check all that apply
Activities you are involved in *
*If you are certified please indicate length of certification below.
Average per month the number of students and/or horses you instruct *
NOTE: Gross Annual Receipts = the total amount of money received before subtracting taxes, costs and expenses.
Are you responsible for 24 hour care of non-owned horses? (either by boarding contracts or horses in training) *

If "Yes" to question above please indicate the Gross Annual Receipts and Average Number of Horses below.

Gross Annual Receipts
Average Number of Horses
Do you currently have a primary farm/ranch policy?
Do you currently have a policy that covers any of the above equine related exposures?
Do you have assistants or partners? *
Do you use volunteers or working students? *

NOTE: This includes anybody offering to take part in equine activities without remuneration. These individuals will NOT be giving lessons or advice as an expert or representative or acting as a person of authority (including any on ground instruction).

If "Yes" on volunteers, how many on average per month?

 

Do you offer any of the following additional activities?

NOTE: A reoccurring student is someone you have frequent contact with and have excellent working knowledge of their horsemanship.

 

Pony / Horse Rides *

Includes traveling or at one location where horses or ponies are led in a round pen or hand held for special events, birthday parties, etc. Nor for reoccurring students (see definition above)

Day Camps

One day or multi day event offering equine activities or anything advertised as a "Camp". (For all events other than reoccurring 1 - 2 hour lessons and no overnight exposure.)

Horse Drawn Vehicle Rides
Fundraisers
Sleigh Rides
Horse Sales

Providing advice on purchase of a horse that is owned by you or not owned by you, whether in your care, custody, control or not. Also, if you receive any kind of remuneration or act as an agent/broker or if you have involvement in a horse auction.

Guided Trail Rides

This includes trail rides led by you, a wrangler or any other party for recreational riding that is open to the general public for any length of time including hourly, long distance and/or multi-day trips.

Trail Rides as part of a lesson

This is for reoccurring students (see definition above) that have trail rides as a part of their regular lesson.

How did you hear about us? *