No Obligation Polo Club Liability Quote
Complete this online form TODAY for an immediate quote!
(click here for a printable version)

All required fields in this form are indicated with a red asterisk: *

*Association Membership: Yes No
If Yes, please indicate which one:

*First Name:

*Last Name:

Mailing Address:

*Street:

*City:

*State: *Zip Code:

*Phone:

Fax:

*Email:

*Number of members:

*Number of days for each of the following activities:
Member Meetings
Clinics
League Matches
Sanctioned Polo Events
Scrimmages
Fun Matches/Play Days

*Number of:
Acres owned/leased
Horses owned by club
Non-owned horses boarded by club

*Does the club give riding lessons? Yes No

*Is liquor served at any of the activities? Yes No

*Do you have any event(s) with more than 1,000 spectators or participants? Yes No

*Do you have any need for additional insured certificates? Yes No
If Yes, how many?

*Optional Coverages: (Please pick the option you wish to have quoted)
(Limits begin with a $1M policy)
Quote for Higher Liability Limits – $2M
Quote for Higher Care, Custody and Control - $100,000/$200,000

All coverages are subject to policy limits, conditions and exclusions. This is NOT an application.
The above information is used for quoting purposes only!

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*Please tell us how you heard about us.

Other/Please Specify (Magazine Ad, Association Member, Event, etc.):