Entertainers Liability Application Form

Personal Information

Contact Information

Liability Coverage Requested






Billing Information



Cruise Line Information

Questionaire
(EXPLAIN ALL "Yes" Responses)

Terms & Conditons

  1. This application will be incorporated in its entirety into any relevant policy of insurance where insurers have relied upon the information contained therein.
  2. Any misrepresentation in this application for insurance will render insurance coverage null and void from inception. Please therefore check to make sure that all questions have been fully answered and that all facts material to your insurance have been disclosed, if necessary by a supplement to the application. N.B. The Confirmation of Insurance cannot be released until the premium payment has been received.
  3. By Clicking the Submit button below, you are stating you understand the insurance wording attached to this application form accept them.
  4. Cancellation and Refund Policy:  You are free to cancel this policy at any time. If you decide to cancel prior to the policy start date, a full refund will be provided. If the policy is on risk, we shall retain the pro rata proportion of the premium for the period this insurance has been in force, subject to the minimum period of 31 days and minimum premium of $250 and providing that no valid claim has been made or is intended to be made and no incident likely to give rise to a claim has occurred.
Execution Information

The completion and signing of this application does not bind the APPLICANT or MHG Insurance Brokers to effect insurance on this risk; it is submitted for purposes of rating and quotation only. If accepted by Underwriters it is agreed the information furnished herein shall be the basis of the contract should a policy be issued.