Event/Wedding Insurance Information Step 1 of 2 50% The Insured InformationName for Insured First Last Address for Insured Street Address City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Phone # for InsuredEmail for Insured Enter Email Confirm Email Would you like to add a second name to policy (ie: bride, groom, parents)? Yes No If yes, add name(s) to policyFull Name Add Remove Venue DetailsName of VenueAddress of Venue Street Address City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Number of AttendeesNumber of Days Event Will Be HeldIs alcohol present at the event? Yes No if yes, it will include liquor liability as long as proper protocols in placeWho is serving alchologic beverages?Venue or CatererThe insured. Servers have formal alcohol awareness training, no BYO permitted and no persons under 21 will be served.The insured, and servers do not have formal alcohol awareness training.Event is BYOB.Attendees can serve themselves.Do you need inclement weather date? Yes No If yes, please let us know the dateDo you need to list any entities as Additional Insured/Venue? Yes No If yes, add additional insured / venue here Add Remove Event/Wedding Insurance Information Step 1 of 2 50% The Insured InformationName for Insured First Last Address for Insured Street Address City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Phone # for InsuredEmail for Insured Enter Email Confirm Email Would you like to add a second name to policy (ie: bride, groom, parents)? Yes No If yes, add name(s) to policyFull Name Add Remove Venue DetailsName of VenueAddress of Venue Street Address City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Number of AttendeesNumber of Days Event Will Be HeldIs alcohol present at the event? Yes No if yes, it will include liquor liability as long as proper protocols in placeWho is serving alchologic beverages?Venue or CatererThe insured. Servers have formal alcohol awareness training, no BYO permitted and no persons under 21 will be served.The insured, and servers do not have formal alcohol awareness training.Event is BYOB.Attendees can serve themselves.Do you need inclement weather date? Yes No If yes, please let us know the dateDo you need to list any entities as Additional Insured/Venue? Yes No If yes, add additional insured / venue here Add Remove
