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What country are you based in?

United States of America

Canada

Do you currently have a Gymnastics Program?

Yes

No

If you selected "Other" above, please name or describe briefly.

When would you like your new insurance coverage to begin? If you’re unsure of the exact date, choose the first day of the month you want coverage to start.

How many students do you estimate will be enrolled in classes? (If you have a range, estimate the highest number of students you may have.)

Do you already have, or plan to have, an open gym?

Yes

No

If you answered yes to the question above, how many students participating in open gym?

How many drop-in students (not enrolled) do you estimate that you will have on a weekly basis, including maximum number per birthday party?

Which would best describe your program?

Elite

Recreational

Do your students participate in Competitions?

Yes

No

Have you ever been denied or dropped by an insurance carrier?

Yes

No

If you answered yes to the question above please explain why.

Have all your instructors completed the SAFE SPORT Certification?

Yes

No

Do you have a Trampoline?

Yes

No

Do you have a Climbing Wall?

Yes

No

If yes, you have a Climbing Wall, what is it's height?

Do you agree to follow all INSURE GYMNASTICS guidelines as posted on this site under our FAQ’s section?

Yes

No

Click here to view our guidelines section.

Gym Name

Contact Name

Contact Email

Contact Phone

Gym Phone

Gym Website

Gym Physical Address

Country/Region

Address

City

Zip / Postal code

Gym Mailing Address (if different from Physical address)

Gym Mailing Address (if different rom physical address.)

Country/Region

Address

City

Zip / Postal code

To reach out directly:

(646) 688 - 2977

certification@insuregymnastics.com