NRA Endorsed Insurance Program - Club Liability Application




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		Club Insurance Application Click here to purchase Hunt Club Insurance If you currently have a policy with us, please call a representative to renew. Club Name: Club Mailing Address: City: State: Zip Code: Contact Person: Phone Number: Fax Number: Email: Are you a Club Affiliate member?: Yes No Club Affiliate Member Number: Current Number of Members: Location Schedule* Location 1 Address: (street, city, county, state, zip, or legal description filed with the local courthouse) Location 2 Address: Location 3 Address: Limits of Liability Effective Date: Current Premium: General Liability Limits Current: $250,000 $500,000 $1,000,000 $2,000,000 Desired: $250,000 $500,000 $1,000,000 $2,000,000 Range Operations and Safety Type of Range: Indoor Outdoor Rifle Skeet, Trap, or Sporting Clay Air Archery Number of lanes Number of fields To What Specifications Are Ranges Built?: Per NRA Guidelines Per own design (as described below) Other Specifications: A Range Safety Program should include all of the following criteria. Please check all that apply to your club: Range Maintenance Program Maintenance log Procedures for cleaning of indoor range ventilation/filtration system Proper dispensing of all spent brass and lead Written Range Safety Program Guideline Range Safety Rules posted Are sufficient backstop, berms, and/or pit exposures maintained for all ranges?: Yes No Is a landowner, club member, or safety officer in control of the range at all times when in operation?: Yes No Do you provide firearms training, safety or instruction?: Yes No Are all instructors certified?: Yes No If yes, NRA Certified Law Enforcement Other Specifications: Do you rent firearms at your range?: Yes No Do you require safety instruction to all new shooters?: Yes No Do you require eye and ear safety protection?: Yes No Spectator Safety: Designated area for spectators No Spectators This is an application for General Liability Insurance Coverage Only. Other types of insurance are available including liquor liability, property, crime and umbrella insurance. Contact our sales department toll-free at 1-877-487-5407 for more information. Questions or Comments: *By submitting your application we can provide you with a competitive quote. You are under no obligation to participate in the program.*


NRA Endorsed Property & Casualty Insurance Program Administered by Lockton Affinity, LLC. Copyright © 2010
All coverage descriptions are a summary and not complete descriptions of all terms, exclusions and conditions in the master policy on file at NRA Headquarters.
NRA Member dues or contributions are not used for this promotion, program or any other related expenses.