Dance Instructor Quote

Dance Instructors – Eligibility

Please select the type(s) of instruction offered by the school/club (select all that apply).

Ballet
Ballroom
Belly Dancing
Clogging
Country Western
Cultural/Ethnic
Flamenco
Folk Dancing
Hawaiian
Hip Hop
Irish
Jazz
Latin
Modern
Salsa
Scottish
Square
Swing
Tango
Tap
ZUMBA (R)

If the styles of dance are not listed above, DO NOT CONTINUE. Please contact our office at 1-209-888-4904.

If you are trying to obtain coverage for both an instructor AND a facility, start with our on-line Fitness Facility or Dance School application.

Desired effective date

In what state is the insured reside?

Is the insured under the age of 18?

Yes
No

Do you conduct operations outside of the United States?

Yes
No

Is the insured currently certified?

Yes
No

If yes, who is the insured certified by?

*If you indicate you are certified, you will be asked later in the enrollment process to provide the certification number and expiration date (if applicable) to complete purchase.

Dance Instructor - Rating

Select one of the Limit of Liability options below.

Option 1: $500,000

1 Year Premium
2 Year Premium

Option 2: $1,000,000

1 Year Premium
2 Year Premium

Option 3: $2,000,000

1 Year Premium
2 Year Premium

Optional Coverages - Abuse, Molestation, Harassment or Sexual Conduct Defense Cost Reimbursement

The coverage reimburses you up to $100,000 per claim / $100,000 aggregate for defense costs from claims.

Do you want to add this coverage to this quote?

Yes (please answer the next 9 questions below)
No (go to facility information)

Are all prospective employees required to complete a written employment application?

Yes
No

Does your employment application ask the applicant if they have ever been convicted of a crime?

Yes
No

Are references obtained and checked prior to hiring a staff member?

Yes
No

Do you have frequent discussions with your staff on the importance of providing a safe environment for the children in your care?

Yes
No

Do you have written procedures for responding to a reported abuse incident?

Yes
No

Is a copy of the written procedure provided to each member of your staff?

Yes
No

Is mandatory notification to local law enforcement included in your written procedures?

Yes
No

Is suspension of the accused employee part of your written procedures?

Yes
No

Has any member of your organization ever been involved in an incident which resulted in an allegation of abuse or molestation?

Yes
No

Facility Information

Number of facility locations:

Insured Information

Named insured (as it should appear on the policy) :

Doing business as (DBA) :

Contact first name:

Contact last name:

Mailing address:

Address Line 2:

City:

State:

Zip:

Phone (including area code):

Fax (including area code):

E-mail: