• Gymnastics Victoria Logo

    2019 Club Change of Insurance Request

    Thank you for choosing to affiliate with Gymnastics Victoria (GV) and Gymnastics Australia (GA) in 2019.

    This form is to be used by clubs who have already completed the 2019 Club Affiliation Form.

    Only complete this form to change your insurance arrangements in 2019 if you have already submitted the 2019 Club Affiliation Form to Gymnastics Victoria.

    The cost of the Gymnastics national insurance program is $1,078.00 for 2019.

  • Gymnastics Victoria Logo

    2019 Club Change of Insurance Request

  • Insurance

    Gymnastics Australia's National Risk Protection Program (the Program) provides four key insurance covers, outlined at the link below.

    The Program utilises the buying power of hundreds of affiliated gymnastics clubs across Australia. This has resulted in considerable savings and enhanced coverage for clubs who purchase these policies.

    1. Personal Accident Insurance: This is Standard Insurance Cover available to registered club members. It covers:

    - Non-Medicare costs;

    - Loss of Income; and

    - Capital Benefits

    associated with personal injuries sustained during official gymnastics club activities.

    The Personal Accident Insurance premium is included within the membership fees for all members. As per the National Affiliation Standards, the club must register all participants in accordance with the National Membership Database Policy to ensure Insurance cover can be confirmed.

    2. General Liability Insurance:

    This policy is available to affiliated clubs. It covers legal liability to pay compensation arising from Personal Injury, Property Damage and Advertising Liability to third parties for breaching its duty of care (negligence).

    3. Professional Indemnity Insurance:

    This policy is available to affiliated clubs. It covers certain costs associated with a claim against the club, its members, employees and officers for a breach of professional duty in the conduct of the club's business.

    4. Management Liability Insurance:

    This policy is available to affiliated clubs. It covers a range of areas including legal action against the committee or directors of the club for wrongful acts or omissions.

    The National Risk Protection Program is administered by Marsh Advantage Insurance (Marsh). For a simple summary of each policy and other important information, terms and conditions, please visit the Marsh website at https://www.marshadvantage.com.au/partner-group/gymnastics/welcome.html.


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  • Gymnastics Victoria Logo

    2019 Club Change of Insurance Request

  • Insurance (cont'd)

    (a) Before you enter into a contract of general insurance, you have a duty, under the Insurance Contracts Act 1984, to disclose to the Insurer (via this form) every matter that you know, or could reasonably be expected to know, is relevant to the Insurer's decision whether to accept the risk of the insurance and, if so, on what terms.

    For further details regarding insurance terms and conditions, please refer to the Marsh Advantage Insurance website https://www.marshadvantage.com.au/partner-group/gymnastics/welcome.html and the Statutory Notice below.

  • (b) After due inquiry, are you aware of any claims, or incidents that may lead to a claim, relating to the following areas? Please tick each applicable box below.

  • If you answered "YES" to any of the questions in (b), please fully describe the relevant details in the field below.

    Please attach supporting documentation including incident reports, injury reports, witness statements and lesson plans where applicable. Contact Gymnastics Victoria for further assistance or information.

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  • (c) Club Declaration:

    In reference to Gymnastics Australia's National Risk Protection Program Insurance policies, I, the undersigned, as authorised representative and on behalf of the club named below declare that after due inquiry I am not aware of any claims, or incidents that could give rise to a claim, other than as noted above.

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  • If you have completed the above declaration please click next

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  • Gymnastics Victoria Logo

    2019 Club Change of Insurance Request

  • Insurance (cont'd)

    Insurance: Opt Out

    The Club is not purchasing Club Liability Insurance Covers through the Gymnastics Australia National Risk Protection Program.

    If you answered "NO" to the question on page 2, please complete the following information.

    (a) All clubs that do not purchase insurance through the Program must supply evidence of pre-existing and current insurance as per the coverage requirements detailed below.

    Failure to supply sufficient insurance documentation or evidence may cause delays with your affiliation.

    (b) Please tick each box below and supply official documentation to verify that your Club's insurance policies comply with Gymnastics Australia's National Insurance Minimum Requirements.

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  • (d) Club Declaration:

    I, the undersigned, as authorised representative of the Club listed below and declare that the insurance policies held by the Club are current and meet ALL of the National Insurance Minimum Requirements as listed above at (b).

    I have attached the Club's Certificate of Insurance and additional insurance documentation, where applicable, that demonstrates the insurance requirements have been met.

    I understand that failure to supply the relevant insurance documentation may cause the Club's affiliation to be declined.

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  • Gymnastics Victoria Logo

    2019 Club Change of Insurance Request

  • Insurance (cont'd)

    The Gymnastics Australia Insurance program does not cover:

    a) Workers compensation insurance / workcover

    b) General building and/or other equipment insurance

  • Please confirm the Club has sufficient cover for:


  • It should be noted that workers compensation insurance is a mandatory legal requirement for all employers (except exempt employers). Contact the WorkCover / WorkSafe authority in your state for further information.

    For a quote on building and contents insurance go to: https://www.marshadvantage.com.au/business-products/businesspack.html.

  • Gymnastics Victoria Logo

    2019 Club Change of Insurance Request

  • Club Change of Insurance - Declaration

    I, the undersigned, declare I am a duly authorised representative of the Club listed below and all of the information supplied in this Form is correct at the time of application.

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  • Thankyou for your time! Please press Submit Form (then wait for up to 2 minutes while the form uploads). You will receive a confirmation email with the information submitted.

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