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 Event Cancellation Application Instructions

  1. Please complete and submit this online application for a free, no-obligation quote.

  2. Please be sure to provide all required information in order to receive a quotation.

  3. Cancellation coverage cannot be quoted nor bound less than 15 days prior to the event. 


Program Information

This is a secure application.  Strong cryptography is implemented via the Secure Sockets Layer protocol.  Our Privacy Policy.

  PDF Application (Fillable)


( indicates required information)

Applicant Information

Name of Company / Organization:

Full Name of Contact:
Street Address:
City, State: ,
Zip/Postal Code:


We will never rent, sell, or share your email address.

Applicant Type:


Claims History

Event been held before and suffered a cancellation loss?


Event Details

Event Classification:
Event Name:
Event Description :


Required if live music of a concert event.


Average Daily Spectators:

Average Daily Participants:

Athletic / Theatrical Participants

Event Date(s):



Venue Details

Location Where Event Takes Place

Venue Name:
City, State: ,
Event Location:


Event Cancellation Coverages
Cancellation - Max Limit per Covered Event: Included
Adverse Weather*:
Named Storms*:
Door Registration Receipts Coverage:

Reduced Attendance:

Reduced attendance means the actual attendance is less than the average attendance for the preceding two years. This coverage is only available if the insured can provide documentation supporting actual attendance for the preceding 2 years.

Return of Exhibitors Fees:

Indemnifies insured for the pro-rated return of exhibitor fees.

Personal Property Coverage Form:
Financial Commitments: Included
Terrorism: Included

*Notes on Weather Coverages


Adverse Weather Coverage is included only if the event cancellation policy is purchased at least 10 days prior to the event effective date.


For events that occur in the states of AL, FL, GA, LA, MS, NC, SC, TX, & VA during the period June 1st through November 30th, adverse weather coverage does not include coverage for named storms. Named storms coverage is available in these states as an option only if the event cancellation policy is purchased at least 15 days prior to the event effective date.



Non-Appearance Coverage:


Scheduled Persons:

Enter the required information to schedule a person(s).

First Name

Last Name

Birth Date










Terms and Conditions

Please carefully review the Terms and Conditions below:

  • Please read all exclusions indicated on quotation.

  • The quotation received is not binding on the Insurer in any way.

  • By clicking 'Submit Application' you are not agreeing to purchase coverage.  Via email, you will receive a free, no-obligation insurance quotation.

  • Any person who knowingly and with intent to defraud any insurance company or another person files an application for insurance containing any materially false information, or conceals for the purpose of misleading information concerning any fact material thereto, commits a fraudulent insurance act, which is a crime and subjects the person to criminal and (NY: substantial) civil penalties. (Not applicable in CO, HI, NE, OH, OK, OR, VT). In DC, LA, ME, TN and VA, insurance benefits may also be denied.
  • Please note that once coverage is bound, the policy cannot be cancelled.

  • The insurance quotation will be based solely on the coverages and limits selected on this application.

  • Please ask your Supple-Merrill & Driscoll, Inc. representative to explain coverage details, exclusions, limits or other provisions of any insurance policy.

Type your name below, to indicate that you have read

and accepted the Terms and Conditions above:





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