• Escape Room Insurance Questionnaire

  • Applicant is:

  • GENERAL INFORMATION

  • 6. Are you open:
  • 8. Does applicant own or lease premises?
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  • 11. Do you require participants to sign a waiver of liability? (If yes, please attach a copy.)
  • 12a. If under 18 years old, do parents or guardians have to sign the waiver also?
  • 13. Do you ever hire sub-contractors/independent contractors that carry their own insurance?
  • 13b. If yes, are certificates of insurance provided?
  • 13c. Do subcontractors name you as additional insured on their policy?

  • ADDITIONAL INFORMATION

  • 1. Parking facilities provided:
  • 1a. If yes, are they lighted?
  • 3. Is security present during open hours?
  • 3a. Closed hours?
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  • 14. Are special parties offered after normal business hours?
  • 14a. If yes, is the general public allowed on premises during this time?

  • ATTRACTION INFORMATION

  • 1. Is escape room(s) locked?
  • 4. Length of Game:
  • 5. Are live actors in the room?
  • 6. Do you use live animals in your escape room(s)?
  • 7. Do you have special effects or devices?
  • 9. Do you use music in your rooms?
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  • Concessions (Food & Beverages)

  • 1. Are food or beverages sold on premises?
  • 2. Are food operations handled by?
  • 2a. If subcontracted, do you obtain a certificate of insurance?
  • 3. Is there cooking on premises?
  • 4. Do you serve alcohol at your operation?

  • SEXUAL ABUSE  (If located in Illinois, this section MUST be completed. If located in other states, complete only if you desire coverage.)

  • 1. Does the applicant perform a criminal background investigation, including sexual abuse or child abuse-related offenses on prospective employees and volunteers?
  • 2. Does the applicant perform a criminal background investigation, including sexual abuse or child abuse-related offenses on existing employees and volunteers?
  • 3. Does the applicant verify employment/volunteer-related references?
  • 4. Does the applicant conduct personal interviews?
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  • 6. Does the applicant have knowledge of any incident which could give rise to, or result in, an allegation of sexual abuse?
  • 7. Has there ever been an allegation of sexual abuse made against the insured?

  • PROPERTY INSURANCE

  • 1. Do you need Building and/or Content Coverage?
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  • 2. Do you need Equipment Coverage?
  • 2a. If yes, total value to insure for?
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  • 3. Do you have tenants?
  • 3a. If yes, do you obtain a certificate of insurance with limits of $1,000,000?
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  • COMMERCIAL CRIME

  • 1. Do you desire coverage for Crime (Employee Dishonesty, Money, Forgery)?

  • COMMERCIAL AUTOMOBILE INSURANCE

  • 1. Does the business title any automobiles or other operating vehicles in the business name?
  • 2. Is insurance coverage needed for owned automobiles?
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  • 3. Do any of the employees, owners or officers drive personally owned automobiles/other vehicles in the course of their work?
  • 3b. Do you verify they have liability coverage?

  • UMBRELLA AND WORKERS' COMPENSATION INSURANCE

  • 1. Do you need a Commercial Umbrella?
  • 2. Do you need Workers Compensation? (If yes, please contact Kevin Morency.)

  • SIGNATURE

  • The information I have provided is true and accurate to the best of my knowledge. I have not willfully concealed or misrepresented any material fact(s) or information. I understand completion of this questionnaire does not compel the company to provide coverage.

  • Questions? 877-244-9090
    Kevin Morency | kmorency@morencyinsurance.com

    Morency & Associates, Inc.
    141 New Shackle Island Rd, Hendersonville, TN 37075

    https://familyfuninsurance.com/escape-room-insurance/

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