ADVENTUREGUARD SUPPLEMENTAL QUESTIONNAIRE – OUTDOOR CLIMBING / Page 1 of 1
THIS IS A SUPPLEMENTAL QUESTIONNAIRE ONLY. PLEASE COMPLETE THE ADVENTURE ACTIVITIES APPLICATION FIRST.
APPLICANT:
Legal Name of Company:
Operating Name:
ROCK CLIMBING OPERATIONS:
1)Please describe the type of climbing equipment that you use:
2)Do you require all participants to use an industry approved rock climbing helmet?Yes No
  1. If NO, under what circumstances will you waive this requirement?

3)Do all clients use an industry approved rock climbing harness? Yes No
  1. If YES, do you use full body or sit harnesses?

  1. If NO, under what circumstances will you waive this requirement?

4)What anchoring method do you use (if applicable)?
5)What belay method do you use (if applicable)?
6)Do you ever allow participants to belay one and other? Yes No
  1. If YES, under what circumstances would this be permitted?

7)Are your guides certified by the Association of Canadian Mountain Guides? Yes No
  1. If NO, please state your guides’ certification(s)?

8)Do you ensure that ALL equipment is inspected and tested according to manufacturer’s specifications? Yes No
  1. If NO, please explain why

9)Do you allow climbers to use personal equipment? Yes No
  1. If YES, describe your policy with respect to screening of personal equipment used by others:

10)Do you offer a belay course? Yes No
  1. If YES, please provide brief outline of your course, including who teaches it, duration, and standards for passing the course:

  1. What is the minimum age to take the belay course?

11)(CAVING ONLY) Please provide percentage of your tours that are:
  1. Vertical
/ %
  1. Horizontal
/ %
  1. Underwater
/ %
  1. Unguided
/ %
THIS IS A SUPPLEMENTARY QUESTIONNAIRE ONLY. A QUOTATION CANNOT BE OFFERED WITHOUT THE COMPLETED ADVENTURE ACTIVITIES APPLICATION.
Premier Canada Assurance Managers Ltd. (WEST) Inc. is one of Canada’s largest Managing Underwriting Agents. The underwriting insurance carrier varies by line of business and region - please refer to specific quote for declaration of the underwriting insurance company(s).
WESTERN CANADA / T / 604.689.1501 / F / 604.689.5663
Rev. Nov 7, 2014 / / ONTARIO & ATLANTIC CANADA / T / 519.850.1610 / F / 519.850.1614