Halloween Special Events Liability Insurance

Inquiry Form
(Pennsylvania Only)
Applicant Name: 
Contact Name: 
Address: 
City: 
    State:     Zipcode: 
Phone: 
E-Mail: 

Requested Liability Limit:

Location of Event:
Street Address: 
City: 
    State:    Zipcode: 


Building Information:

What was the original occupancy of the building you are using? 

Construction: 

Approximate Age of Building: 

Number of Stories:            Sprinklered?  YES     NO       # of Fire Extinguishers: 

Date last inspected by Fire Department: 

Number of Exits:    Are they lighted?  YES      NO

Number of Stairways:      Are they lighted?  YES       NO

Are unused upper building stories barricaded and marked?  YES        NO

If you are having a maze, number of acres of maze: 


Special Effects/Layouts/Operations
Are they any slides?  YES     NO      If "YES", Number of Slides: 

Are slides adequately lighted at top?  YES     NO           Bottom?  YES     NO

Are there any ramps?  YES     NO
   If "YES", please describe ramps:
   

Are there any removable/dropping floors?  YES     NO

Live Actors?  YES      NO
   If "YES", is the touching of customers by actors permitted?  YES     NO

Are guides used?  YES      NO
   If "YES", what is the minimum age of any guide: 

How many customers allowed in each group? 

Are guides stationed at beginning and at end of each group?  YES        NO

Ratio of guides to customers?   i.e. 1 to 6      2 to 10

What is the minimum age of supervisors? 

Is a security service utilized?  YES      NO        Armed        Unarmed

Describe in detail special effects (such as mechanical devices, swords, knives, hangman ropes, strobe lights, open flames, etc.

Is parking provided by the applicant?  YES     NO

Are all personnel trained in First Aid?  YES     NO
 

Days of Operation:
What is the first day of operation:        Last Day: 

What days of the week is the risk open for customers?

Sunday Monday Tuesday Wednesday Thursday Friday Saturday

Is coverage needed for any days NOT open to the public?   YES     NO

Cost per person for entry
 Estimated total attendence:
 Estimated gross sales:


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McGRATH  INSURANCE  GROUP

4170 William Penn Highway     Murrysville, PA.   15668-1890
(724) 327-8474   (Fax) 327-7911
Toll-free: 1-800-977-2999    Fax: 1-888-800-0034