Online Studio Application

Please fill out and submit the application below. Before proceeding, please note:

  • This program is specifically designed for small studios under 4000 square feet with Personal Training, Aerobics, Pilates, Circuit Training and Massage.
  • Multiple locations must complete a separate application for each location.
  • Items marked with an asterisk (*) are required.

The following fields are required for submission and may contain errors:

Business Type*:
Facility Type*:

Home Mailing Address*:

Are you a member of IHRSA?

Would you like information on IHRSA?

Do you offer CrossFit?

We do not currently offer coverage for CrossFit.

Other business operations as name insured?

Have you been cancelled or non-renewed?

Any liability or property claims last 3 years?

Provide # of Employees & Independant Contractors: Full-Time Part-Time
Personal Trainers:
Fitness/Group Instructors:
Yoga Instructors:
Massage Therapists:
Other:
Totals (from above):

(*EXLUDING: free weights, steps, mats, bands, and balls.)
#
Do you produce videos?
Are any products manufactured or sold under your label?
Do you require signed waivers from all clients?
Do you have defribrillators(s) on premises?
Is signage used throughout facility to prevent injury?
Do you sublease any space to others?
Do you have Automated External Defibrillators (AED)?

Property Insurance Application

Subject of Insurance Limits Deductible Written w/ 90% Coinsurance, RC Valuation & Special Form Coverage.
Contents and Equipment: $ $1000 Employee Dishonesty Coverage:
Tenant Improvements:
(If you lease/rent)
$ $1000 Boiler & Machinery Coverage:
Business Income:
(If not sure enter %75% of total revenues)
$ 72hr Wait Business Income max = 12 mo.

All information below must be completed in order to process the application.

Construction Type:
Number of Stories:
Basement?
Year Built:
Total Sq. Ft.:
Sq. Ft. You Occupy:

Other occupancies in building?

Please enter other occupancies: (please enter a comma after each occupancy)

Is the building over 25 years old?

Please enter the last year of update for the following:

Roof: Wiring: Plumbing: Heating:
Burglar Alarm:
Fire Alarm:
Is Building
Sprinklered?

Policy Effective Date is upon approval.

Word Verification:

Word Verification 
Please enter the letters or numbers you see above