Hunt Lease Liability Application
click here to download a PDF application that can be mailed or faxed.
If you have any questions, problems, or concerns
please contact Outdoor Underwriters at 1-866-961-4101.
Hunt Club Name* | Email Address* | ||
Representative* | Main Number* | ||
Mailing Address* | Mobile | ||
Fax | |||
City* | |||
State* | How did you find us?* | ||
Zip* | Please describe | ||
Number of Acres* | |||
Desired Effective Date* | |||
Premises Posted or Fenced?* | |||
Number of Members* | Average Number of Guests at any time* |
||
Guests Allowed?* | |||
Present Carrier | |||
Expiration Date | |||
Losses in the Past Five Years |
$50,000 Annual Aggregate
$1,000 Deductible
Number of Landowners* |
Please list all of your landowners below (Include name and address). Also list County and State for acres leased.
How would you like to add landowner information?*
Landowner Name* | Main Number* | ||
Representative* | Fax | ||
Address* | |||
City* | Number of Acres Leased* | ||
State* | Location of Acreage* | ||
Zip* | Additional Insured* |
Payments are accepted over the phone via Visa, MasterCard, or by Check/Money Order in the mail.
Coverage under this program is for non-commercial hunting operations. Guided hunting, outfitting, and other for-profit hunting operations are specifically excluded.