Balance for Cyclists | Event Accident & Cancellation Quote Machine

1

CONTACT INFORMATIONPlease enter your contact details.

Contact Name

Contact Email

Contact Phone

2

BUSINESS INFORMATIONPlease enter your client or business details.

Business Name

Business Street Address 1

Business Street Address 2

Business City

Business State

Business Zip Code

3

EVENT INFO (1) | NAME & LOCATIONPlease enter details about the event.

Event Name

Is the Event Address the same as the Business Address?

Event Street Address 1

Event Street Address 2

Event City

Event State

Event Zip Code

4

EVENT INFO (2) | DATESPlease enter the dates of your event here.

5

EVENT INFO (3) | PARTICIPANTSHow many participants will there be?

Enter Number of Participants

6

EVENT INFO (4) | DESCRIPTIONIn a few words, please tell us about your event.

7

EVENT INJURY INSURANCEWould you like to get a quote for Event Injury Insurance?

YESNO

8

EVENT CANCELLATION PROTECTIONWould you like to get a quote for Event Cancellation Protection?

YESNO

10

TERRAINPlease select the terrain that best matches your event.

Flat

Hilly

Mountains

Mixed

11

SURFACEPlease select the surface that best matches your event.

Paved

Groomed Trail

Ungroomed Trail

Mixed

12

COURSE SUPERVISIONHow will your event's course be supervised?

Closed - Police Supervised

Closed - Volunteer Supervised

Open - Police Supervised

Open - Volunteer Supervised

Open - Unsupervised

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SEASONIn what season will your event take place?

Winter

Spring

Summer

Fall

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TIMEWill your event take place during the day or night?

Day

Night

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DURATIONHow long is your event?

Single Day

Multi Day

24 Hour

Recurring

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DIFFICULTYPlease select the difficulty that best matches your event.

Technical

Non-Technical

Mixed

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RIDER EXPERIENCEPlease check all boxes that match your riders' experience level.

Professionals

US Cycling Cat Riders

Amateurs

Novices

Seniors (over 60)

Youth (under 18

18

ACCIDENT HISTORYPlease select the accident history that best matches your event.

No Accidents

Accident(s), no serious injuries

Accident(s), with serious injuries

No Previous History

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EVENT CANCELLATION (1) | INSURED VALUEDoes the Sponsor(s) elect to insure the Total Expenses, Total Gross Revenue or another amount?

Choose One

Enter the Amount to be Insured in USD

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EVENT CANCELLATION (2) | HISTORYHas this Event been held before? If yes, how many times in all, at this location, and at this time of year?

Has this Event been held before?

How many times?

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EVENT CANCELLATION (3) | REFUND POLICYDo you have a Participant Refund Policy?

Yes, there is a refund policy.

No, there is not a refund policy.

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EVENT CANCELLATION (4) | ADVANCE SIGN UPSWhat percentage of participants sign up or / revenue generated in advance of the Event?

Enter a percentage.

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EVENT CANCELLATION (5) | SET UP TIMEHow much set up time, in hours, is needed before the Event begins?

Enter the hours of set up time.

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EVENT CANCELLATION (6) | PAST INCIDENTSHas this or any Event in which the Sponsor(s) was involved in managing had any incident that resulted in any of the following? (Check all that apply.)

Cancellation

Abandonment

Postponement

Interruption

Curtailment

Relocation

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EVENT CANCELLATION (7) | PAST INCIDENTSIf you selected any option from the previous question, please explain here.

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EVENT CANCELLATION (8) | POSSIBLE INCIDENTSAre you aware of any matter, fact, circumstance or incident existing or threatened that might reasonably result in Cancellation, Abandonment, Postponement, Interruption, Curtailment or Relocation of the Event(s)?

Choose One

If you answered yes, please explain here.

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CALC: NUMBER OF DAYS(This should not be visible in the live form. Used to calculate final pricing.)

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CALC: PARTICIPANT DISCOUNT(This should not be visible in the live form. Used to calculate final pricing.)

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CALC: EVENT TYPE FACTOR(This should not be visible in the live form. Used to calculate final pricing.)

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CALC: TERRAIN FACTOR(This should not be visible in the live form. Used to calculate final pricing.)

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CALC: SURFACE FACTOR(This should not be visible in the live form. Used to calculate final pricing.)

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CALC: COURSE SUPERVISION FACTOR(This should not be visible in the live form. Used to calculate final pricing.)

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CALC: SEASON FACTOR(This should not be visible in the live form. Used to calculate final pricing.)

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CALC: TIME FACTOR(This should not be visible in the live form. Used to calculate final pricing.)

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CALC: DURATION FACTOR(This should not be visible in the live form. Used to calculate final pricing.)

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CALC: DIFFICULTY FACTOR(This should not be visible in the live form. Used to calculate final pricing.)

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CALC: RIDER EXPERIENCE FACTOR(This should not be visible in the live form. Used to calculate final pricing.)

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CALC: ACCIDENT HISTORY FACTOR(This should not be visible in the live form. Used to calculate final pricing.)

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CALC: RISK MULTIPLIER(This should not be visible in the live form. Used to calculate final pricing. Sum of factors.)

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COST: PER RIDER PER DAY(This should not be visible on the live form.)

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COST: PER RIDER DURATION(This should not be visible on the live form.)

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COST: DAILY PREMIUM(This should not be visible on the live form.)

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COST: TOTAL PREMIUM(This should not be visible on the live form.)