RDA | Affinity Equine Insurance

RDA Australia Centre Survey

Please answer the in respect for the previous 12 monthas the the submission is on the basis of the actual activities over the last 12 months.

RDA Australia Survey

Centre Name

Legal Entity

Number of Participants

Number of Participations

The total number of sessions attended of the year - eg 100 members ride 40 times a year = 4000 participations.

Number of Riding Volunteersn (including Coaches)

Number of Non Riding Volunteers

Centre Turnover

$

Total revenue derived from the centre in the last 12 months

State

Are all horses owned by the centre?

Please provide further details

Are any RDA horses used for non RDA activites?

Please provide further details

Property Details (add all property addresses requiring cover)

Address

Address

Address

Address

City

City

State

State

Zip/Postal

Zip/Postal

Is the property owned, leased by the centre, or leased on behalf of the centre??

Please provided further details

Do any non RDA activities occur at the premesis?

Please provided further details

Does the centre hire the facility to third parties?

Please provided further details

Does the general public have access to the premises? (eg, dog walkers)

Please provided further details

Does the general public have the right to utilise the property and/or premises or parts thereof?

Please provided further details

Please provide any further relevent information

If you are human, leave this field blank.

Sending

Aon Risk Services Australia Limited (ABN 17 000 434 720 AFSL 241141) act as agent for Liberty Specialty Markets (ABN 61 086 083 605) and authorise Affinity Insurance Brokers Pty Ltd (ABN 15 091 944 580 Authorised Representative No. 1288354) to provide financial services on its behalf under this authority.

This Policy is written using Section 2 - Public Liability of the Affinity Equine Protection Policy Wording.
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