New Annual Policy

Policy Holder Account Information

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Policy Holder Trade / Service Information
Select all that apply.
If you provide Water Aerobics and/or Water Yoga services, check all boxes that apply to your business. (+$100.00)
Only if required by state
Annual Membership - Policy Specification

Please specify your preferences from these options. Some may affect the final price of your purchase.

Your membership will provide you with insurance as an individual only. Often your landlord or place of work or trade show require that they be listed on your Certificate of Insurance as an Additional Benefit Holder specifically for your work. Additional Benefit Holder is not for other professional providers as they must have their own individual policy. There is a $10 charge for each additional insured. NOTICE: Additional Insureds must be added each year. They do not automatically carry over from your previous policy.


Policy Holder Contact Information
Policy Holder Mailing Address
Note: PO Boxes for ID, ND, NY, PA, and TX are not allowed. You must enter a street address.
Billing Address
Claim History

Have you had any liability claims, or are you aware of any incident(s) within the last five years that may result in a liability claim?

Sponsor Code

Enter a sponsor code for this order.

Terms & Conditions
By checking this box I accept the Excluded Modalities & Services in this policy.
By checking this box I accept the Terms & Conditions


Policies are 100% fully earned. No refunds will be given.

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