Dance Insurance Application - Chappell Insurance Agency

Fill your apps out Online! After opening the appropriate .pdf document in Adobe Acrobat, simply place your cursor on the line you need to fill in and begin typing. Once you have completed the application, you may print the form out and fax it back to the number located on the application. If you have Adobe Acrobat Writer, you will be able to save the document to your computer and attach it to an email. If you do not have the software to open .pdf files, you can download Adobe Acrobat Reader for free.

	Individual Applications

RPG Inland Marine Quote Request Form for Facilities

1453 (2/22) RPG Inland Marine Quote Request Form for Facilities

Certificate of Insurance Request Form

2270 (3/22) Facility Certificate of Insurance Request Form

Dance School Insurance Enrollment Form

1017 (11/23) Dance School & Programs Insurance Enrollment Form
This brochure is valid for effective dates of 1/1/2024 through 12/31/2024.

Dance Schools and Programs Supplemental Request Form

1596 (3/21) Dance Schools & Programs Supplemental Request Form - Use this form if you need to add additional coverage, add additional
participants to existing coverage or need to request additional certificates.