Firearms Training-Supplemental Application GENERAL INFORMATIONBusiness Name Effective Date MM slash DD slash YYYY Website Current Carrier InformationCurrent Carrier Limit of Insurance Deductible Premium Offering renewal? Yes No Claims made? Yes No Retroactive date MM slash DD slash YYYY Please attach copies of the followingCurrently valued five year loss runs, including claim detail for all losses open or exceeding $15,000 Drop files here or Select files Max. file size: 512 MB. Product brochure, catalog, or marketing materials if a website is not available Drop files here or Select files Max. file size: 512 MB. Copies of all course materials, guides, and maps as applicable Drop files here or Select files Max. file size: 512 MB. What are your operations? Check all that apply Firearms Training – Basic Safety and Use Firearms Training – Self-Defense – No Contact Firearms Training – Self-Defense – Including Disarm/Martial Arts Training Firearms Training – Armory/Gunsmithing and Ammunition Reloading Firearms Training – Advanced Tactical – Civilian Firearms Training – Advanced Tactical – Law Enforcement, Military, or Licensed Security Firearms Training – With Tactical Driving Firearms Training – Trick Shooting or Film/Television Instruction Firearms Training – Marksmanship/Professional Target Shooting Bladed Weapon Training Guided Hunt – On Foot/Trail Guided Hunt – Utilizing Land or Marine Vehicles Guided Hunt – Utilizing Aircraft or Rotorcraft What are your projected receipts for the coming year?Do you operate seasonally only? Yes No What is your operating season? Are you subject to any state or local licensing or regulation? Yes No List regulations/licensesHow many years have you been in operation? Do you run criminal background checks on all employees? Yes No Are past convictions for violent crimes or organized crime, or “no fly list” restrictions exclusionary criteria for hiring? Yes No What is the minimum age for employment? Does your operation have any age restrictions for participants? Yes No What age? Do you strictly prohibit the use of firearms by any participants under the influence of drugs or alcohol? Yes No Are all participants required to sign a waiver absolving you of all liability for bodily injury and property damage, including any damage to their firearms? Yes No Please indicate the personal protective equipment required when firearms are being dischargedEar Protection? Yes No Eye Protection? Yes No Other Do you have the following first aid measures readily accessible in all areas where firearms are dischargedBasic first aid kit? Yes No First aid trained staff? Yes No Advanced aid kits (such as gunshot, hemorrhage, tourniquet)? Yes No Emergency alert button/911 call button? Yes No FIREARMS TRAININGHow many students maximum will you train at one time? Do you allow students to bring their own firearms? Is classroom instruction completed and students assessed prior to any range instruction? Yes No Do you instruct classes for students to satisfy a state or local requirement to obtain firearm permitting such as a concealed carry license? Yes No Do state or local requirements mandate that you conduct any kind of student screening? Yes No Please describe: Does passing the course require a mandatory minimum proficiency? Yes No What is the minimum accuracy threshold? Do any courses you offer involve live fire training/practice? Yes No is this at a range you own, operate, or are an employee? If yes, please complete Kinsale Shooting Range Supplemental Application and provide detailed diagrams of range(s) Yes No Do any courses offered require any special state or federal reporting? Yes No Please describeAre students aware of this reporting requirement? Yes No Do you have any restrictions on course participation based on violent crimes, active restraining orders, involuntary psychiatric holds, or “no fly” listings? Yes No If you conduct any self-defense training or bladed weapons training, please complete the followingAre all hand-to-hand training modules conducted with dummy weapons incapable of firing a projectile? Yes No Are modules conducted with nonlethal weapons only (paint projectiles, Taser, etc.)? Yes No Describe the safety equipment utilized during hand-to-hand training modules (mats, headgear, etc.)Are students instructed to or permitted to spar with one another? Yes No If your conduct any advanced tactical courses, please complete the followingDoes any course work involve climbing or rappelling? Yes No Do any course modules involve exposure to extreme elements or pain, including severe temperatures, loud noises, strobing lights, obfuscated vision, low lighting, electroshock devices, chemical irritants, visually disturbing imagery or scenery, harassment or humiliation, explosions, fire, sleep deprivation or other severe high stress conditions? Yes No Are these modules conducted with live firearm/lethal projectiles present? Yes No If you are conducting tactical driving courses, do students complete driving modules in their own vehicles? Yes No Are students permitted to fire weapons from the driver’s seat? Yes No Are students required to stop the vehicle before discharging? Yes No Are any courses conducted over multiple days? Yes No Do you provide overnight accommodations? Yes No Are accommodations considered to be backwoods or primitive camping in nature (no access to running water, conventional plumbing, or electricity)? Yes No Do you provide meals? Yes No Do you serve or permit BYOB alcohol consumption? Yes No Do you require all firearms to be unloaded and locked before alcohol may be consumed? Yes No GUIDED HUNTSWho maintains the trails/areas where hunts occur? Do you confirm the validity of all participant hunting licenses before the hunt commences? Yes No Do you conduct a safety presentation before the hunt commences? Yes No Are participants required to wear high visibility vests or clothing? Yes No Are participants required to wear high visibility vests or clothing? Yes No Does your presentation include an overview of local, state, and federal limitations on hunting (size limitations, protected species, scope of license/season, etc.)? Yes No Do you conduct hunts of any apex predator/high predator game such as bears, alligators, or wild boar? Yes No Do you conduct hunts in areas where apex predators are known to have habitats? Yes No Do you conduct hunts using weapons other than firearms (bows, trapping)? Yes No If you are utilizing non-aircraft vehicles, please complete the followingAre participants permitted to drive? Yes No Are participants required to place the vehicle in park before shooting? Yes No Are you utilizing any watercraft? Yes No Are participants required to wear a US Coast Guard approved life vest? Yes No If you are utilizing aircraft or rotorcraft, please complete the followingAre flights conducted open door? Yes No How are participants secured in the aircraft? Yes No Does any portion of the flight path go over water? Yes No Are all passenger restraints designed to allow for rapid egress? Yes No How many pilots do you employ or contract? How many flight hours does each pilot have in the type of craft you are operating? Do you own the craft you use? Yes No Are you responsible for regular maintenance of the craft? Yes No Do you carry aircraft liability insurance including passenger and public liability? Yes No Are any hunts conducted over multiple days? Yes No Do you provide overnight accommodations? Yes No Are accommodations considered to be backwoods or primitive camping in nature (no access to running water, conventional plumbing, or electricity)? Yes No Do you provide meals? Yes No Do you serve or permit BYOB alcohol consumption? Yes No Do you require all firearms to be unloaded and locked before alcohol may be consumed? Yes No ACCOUNT HISTORYDuring the past five years, has any insurer ever canceled or non-renewed similar insurance to any applicant or has your insurance been canceled for nonpayment of premium by any insurance or finance company. Yes No Please attachMax. file size: 512 MB.Please explainIs your company aware of any occurrences, facts, circumstances, incidents, situations, damages or accidents arising out of or related to your operations that a reasonably prudent person might expect to give rise to a claim or lawsuit whether valid or not which might directly or indirectly involve the company? Yes No Please attachMax. file size: 512 MB.Please explainApplicant Title FEIN # Date MM slash DD slash YYYY
