Name of Club Group or Society*
Contact Name*
Contact phone Number*
Contact Email Address*
Address (inc Postcode) of premises used*
Main activity of your Group*
Total number of members*
Total number of Employees including volunteers*
What datte would you like cover to start*
Public Liability Limit of Indemnity*
Employers Liability (inc volunteers)*
Business Interruption*
Money Cover*
Trustee Indemnity*
Personal Accident*
All Risks*
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