Prizetech - Non Appearance Questionnaire

To complete this questionnaire for an event non-appearance, simply answer all the questions outlined in the form below. Our team will then be in touch shortly to discuss.

All fields marked with an * are mandatory.

What perils are required? *Please refer to the policy wording to determine the extent of coverage offered. The numbers relate to the optional perils specified in the policy wording.

For the purposes of any insurance granted as a result of this Proposal, coverage shall be limited to those individuals detailed below and stated in the Schedule attached to the Policy. Underwriters may require any of the following individuals to undergo an independent medical examination.

Persons to be insured *

Date of Birth *

Participation/Role *

Has any provisions been made for understudies, substitutes or stand-bys? *

YesNo

Please provide full details *

Is any person to be insured suffering from any physical, mental or medical condition? (The proposer shall consult the person(s) detailed in question 2 before answering the following) *

YesNo

Please provide full details *

Is any person to be insured undergoing any form of treatment, medical or otherwise? *

YesNo

Please provide full details *

Is any person to be insured following any prescribed regime, medical or otherwise? *

YesNo

Please provide full details *

Is any person to be insured aware of any matter, fact, circumstance or incident existing or threatened that could possibly affect the performance(s) or event(s) and might result in a loss under the proposed insurance? *

YesNo

Please provide full details *

Have any of the persons to be insured stated in question 2 any history of non-appearance whether or not it resulted in Cancellation, Abandonment, Postponement, Interruption, Curtailment or Relocation of an Event? *

YesNo

Please provide full details *

What method of transportation will be used by the person(s) to be insured? *

What method of transportation will be used for equipment or items essential to the Insured Performance(s) or Event(s) *

Is the means of transportation to be used customised or adapted for the purpose? *

YesNo

Is an alternative means of transportation available? *

Have written contracts been signed for the appearance of all the persons shown in question 2? *

YesNo

Please provide full details *

Have all necessary licences, visas and permits and authorisations been arranged for the Insured Person(s) *

YesNo

Does the Proposer(s) undertake to make all such remaining contractual arrangements in a prudent and timely manner and ensure they are confirmed in writing prior to the relevant Insured Event(s)? *

YesNo

Please provide full explanation *