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 Hole-In-One and Putting Contest 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.


  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:


Insurance History
Any insurance declined or cancelled in the past 3 years? Yes  No
Any prior insurance coverage? Yes  No
Any loss in the past 3 years? Yes  No


Facility and Course

Golf Facility Name:
State of Club or Facility:

Name of Course:

If Multiple Courses

Tee Level:

Slope Rating:

A term trademarked by the USGA


Event Details

Provide the name and date of event and number of contestants. Eligible contestants include amateurs, non-touring professionals, and touring professionals on any tours except for the PGA, LPGA, and Champions Tour. Professionals on the PGA, LPGA and Champions Tour are not eligible.

Event Name:
Event Date(s): to
Amateurs: Any golfer other than a professional.
Non-Touring Pros: Professionals that do not play on any tours.
Touring Pros: Professionals other than PGA, LPGA, and Champions Tour Players.


Hole-In-One Contests


Hole Number Distance (yards) Prize Amount


Note:  The minimum distance is 150 yards.  Women may shoot at the specified hole(s) at a distance of up to fifteen (15) yards less than the yardage chosen, subject to 135 minimum yardage.


Optional Coverage - Prize Restoration

The prize is only available for the first hole-in-one on the scheduled hole.  Selecting prize restoration restores the prize value for a second eligible recipient on the same hole.  Prize restoration applies to each scheduled hole but does not apply to putting contests.

Include Prize Restoration Coverage



Putting Contest

A putting contest usually has two or more rounds. All golfers participate in the first round. Sinking the putt advances the golfer to the next round. If no one sinks the putt, the closest advances. The rounds continue until there is a final field. The number of participants in the final field equals the attempts selected below. Each participant in the final field gets a single chance to putt for the prize.


Distance (feet) Number of Attempts Prize Amount

(Between 40 and 80)

(The number of attempts represents the number of contestants eligible to putt in the final round for the prize)

(Up to 25,000)


Note:  The minimum distance is 40 feet.  Women may shoot at the specified hole(s) at a distance of up to fifteen (15) yards less than the yardage.








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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