Hunting Guide Insurance Questionnaire

Hunting Guide Insurance Questionnaire
Applicant's Name:*
Address:*
Mailing Address
Address (cont):*
Mailing Address - continued
Contact:*
Email*
Telephone:*
Website
Fax:
Applicant is:

IndividualPartnershipCorporationOther (specify)
Current Carrier:
Expiration Date:
Limits: ($)
Premium: ($)
Deductible: ($)
General Information
1. Please describe all aspects of your operation:
2. How many years have you been in business?
2a. If you are a new venture, how many years prior experience in this type of operation?
3. In what state(s) do you guide in?
4. What are the gross receipts from this operation?
5. Do you require participants to sign a waiver of liability? (If yes, please attach a copy.)

YesNo
6. Are tree stands used?

YesNo
6a. If yes, do you require a full body harness?

YesNo
6b. If yes, do you give instructions on the safe way of getting into and out of the stand?

YesNo
7. Are shooting platforms used? (A shooting platform is free standing and not near a tree.) If yes, please attach photo(s).

YesNo

8. Do you use any of the following to transport hunters?

9. Are any of the above rented to others for other than hunting purposes?

YesNo
10. Do you hire guides as subcontractors?

YesNo
10a. If yes, do you obtain certificates of insurance?

YesNo