• Paintball & Airsoft Insurance Questionnaire

  • Applicant is:

  • GENERAL INFORMATION

  • 3. Are fields outdoors?
  • 3d. Are games played after dark? (If yes, provide a copy of night time rules of play.)
  • 3di. If yes, is adequate lighting provided?
  • 3f. Are players made aware of these hazards?
  • 4. Are fields indoors?
  • 4d. Is the building leased?
  • 4e. Is protective covering for walls and ceiling provided?
  • 4. Is emergency lighting provided?
  • 4g. Are exits marked?
  • 5. Are safety briefings conducted for all players on game safety?
  • 6. Do staging areas have posted safety rules and are they supervised at all times?
  • 7. Are “Goggles On” signs posted at all entrances to play fields?
  • 8. Are “Barrel Blocking Devices Required” signs posted at all exits from play fields?
  • 9. Do you allow smoking or drinking before or during games?
  • 10. Are spectators properly protected from the paintball area?
  • 11. Do you use inflatables as obstacles on the course?
  • 12. Are there any climbing structures 3 feet or higher used in the area of play? (If yes, we require photographs of any towers, castles or other climbing structures. )
  • 12a. Are steps or ramps or handrails used on all climbing structures?
  • 12b. Are there grip tapes on the ramps and stairs?
  • 13. Do you have or assign a referee to each game played?
  • 14a. Do all minors have parents/guardians sign their waivers? (Please provide copy of waiver.)
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  • 16. Do you perform any repairs or modifications to customer’s markers?
  • 17. Are other services or activities provided on premise?
  • 18. Do you sponsor any OFF PREMISE events?

  • EQUIPMENT SAFETY

  • 1. Do you examine and maintain the equipment you lend out daily?
  • 2. Are facemasks or goggles required and is their usage enforced?
  • 3. Do you have anti-fogging eye protection equipment?
  • 4. Can players use fog free equipment for an additional charge?
  • 5. Do you allow players to bring their own equipment?
  • 5a. If yes, do you allow automatic, or modified markers?
  • 6. Do you inspect equipment brought onto the premise and recalibrate markers if necessary?
  • 7. Do you have a minimum of one working chronograph at all times?
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  • 9. Are you or your employees trained or certified to fill and refill CO2 cartridges?
  • 10. Do you allow players to fill their own tanks? (If yes, please explain procedure on separate sheet.)
  • 11. Are all markers required to have barrel plugs and safety locks?

  • CONCESSIONS (Food & Beverages)

  • 1. Do you offer food and beverage concessions?
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  • 2. What is restaurant exposure?
  • 3. Is fast food delivery service available?
  • 4. Are food operations handled by?
  • 4a. If subcontracted, is certificate collected?
  • 5. Is there cooking on premises?
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  • 6. Is there a 40 BC fire extinguisher in the kitchen?
  • 7. Are all cooking surfaces covered by an UL300 Extinguishing system?
  • 8. Are hoods/ducts cleaned by contractor?
  • 8a. How often?
  • 9. Do you serve alcohol at your operation?
  • 9c. Will you allow others to serve alcohol at this event? (If yes, Certificates of Insurance are required.)

  • Note: If Liquor Liability coverage is desired, please contact Kevin Morency for a quote. (Liquor Liability will only be available if we provide the General Liability for your agritainment operation.)

  • SEXUAL ABUSE (If located in Illinois, this section MUST be completed. If located in other states, complete only if you desire coverage.)

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  • 2. Does the applicant verify employment/volunteer-related references?
  • 3. Does the applicant conduct personal interviews?
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  • 5. Does applicant have supervision plan to monitor staff in day-to-day relationships with clients/children?
  • 6. Does the applicant have knowledge of any incident which could give rise to, or result in, an allegation of sexual abuse?
  • 7. Has there ever been an allegation of sexual abuse made against the insured?

  • COMMERCIAL CRIME

  • 1. Do you desire coverage for Crime (Employee Dishonesty, Money, Forgery)?

  • PROPERTY INSURANCE

  • 1. Do you need Building and/or Content Coverage?
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  • 2. Do you need Equipment Coverage?
  • 2a. If yes, total value to insure for?
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  • COMMERCIAL AUTOMOBILE INSURANCE

  • 1. Does the business title any automobiles or other operating vehicles in the business name?
  • 2. Is insurance coverage needed for owned automobiles?
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  • 3. Do any of the employees, owners or officers drive personally owned automobiles/other vehicles in the course of their work?
  • 3b. Do you verify they have liability coverage?

  • UMBRELLA AND WORKERS' COMPENSATION INSURANCE

  • 1. Do you need a Commercial Umbrella?
  • 2. Do you need Workers Compensation? (If yes, please contact Kevin Morency.)

  • SIGNATURE

  • The information I have provided is true and accurate to the best of my knowledge. I have not willfully concealed or misrepresented any material fact(s) or information. I understand completion of this questionnaire does not compel the company to provide coverage.

  • Questions? 877-244-9090
    Kevin Morency |  kmorency@morencyinsurance.com 

    Morency & Associates Inc.
    1194 Long Hollow Pike, Gallatin, TN 37066
    Fax: 615-452-6580

    https://familyfuninsurance.com/

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