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Hunting Lease Liability Insurance

Please fill out the online application below or
click here to download a PDF application that can be mailed.

If you have any questions, problems, or concerns
please contact Outdoor Underwriters at 1-866-961-4101.

Policy/Coverage Information

You are applying for Hunting Lease Liability Insurance.

To participate in this program, you and each of your landowners must be current members of Arkansas Forestry Association. If you are not, you will be able to purchase your membership(s) below. Please also remember that you must have a written lease with each landowner in order to take out this coverage.

You will receive an email notification when your application has been approved and your policy is activated. You will then be able to log into your account to download a copy of your policy.

Hunting Club Information

Hunt Club Name*

Number of Members*

Representative*

Main Number*

Address*

Secondary Number

Fax Number

City*

Email*

State*

Password*

Zip*

Confirm Password*

Does the Hunt Club or Hunt Club Representative have a current AFA membership?*
Yes No

Which NWTF chapter do you belong to?

A 1-year AFA Membership has been added. Dues are based on number of members.
Information and a membership card will be mailed from AFA to the address above.

Enter your email address and a password to create your account
so that you can later access and manage your policy online.

Your email address and personal information will be kept private.
- Ed Wilson, PhD., Vice President - Outdoor Underwriters, Inc.
- Tom Skaggs, Account Executive - Outdoor Underwriters, Inc.

Landowner(s) Information

Name of Landowner*
Representative
Address*

City*
State*
Zip*
Does this Landowner have a current AFA membership?* Yes No A 1-year membership has been added. Dues are based on acreage. Information and a membership card will be mailed from AFA to the landowner's address above.

Main Number
Secondary Number
Fax Number
Email

Number of Acres Leased*
Location of Leased Property*
For an additional $26.00, this landowner has been named as an Additional Insured. Would you like to keep this?* Yes No Your landowner will not be covered in the event they are brought into a hunting club claim.

Need to list another landowner? Click the button below...

Coverage Dates

Choose your desired effective date.

January 1, 2012 through January 1, 2013

Effectve Date will be the day your policy is activated.
Premium will not be pro-rated.

April 1, 2012 through April 1, 2013

Effectve Date will be the day your policy is activated.
Premium will not be pro-rated.

August 1, 2012 through August 1, 2013
October 1, 2012 through October 1, 2013

Payment Calculation

Base Premium: Base premium is per acre leased (--) and a minimum of --	--
Total Amount Due:	--

Payment

Pay by Credit Card (Visa or MasterCard only)

Cardholder Information

Please enter the cardholder's name and billing address
Name on Credit Card*	Card Type*
Billing Address*	Card Information*	Securely Enter Card Information
	Card Number
City*	Card Expiration
State*
Zip*

Pay by Check / Money Order (Mail in after submitting your application)

Check Information

Write a check made payable to "Outdoor Underwriters, Inc." in the amount of -- and enter the check information below. If you intend to mail a money order, disregard the textboxes below.
Checkholder's Name
Check Number
After submitting your application, mail your check or money order to: Outdoor Underwriters, Inc. RE: Application 140 Stoneridge Drive, Suite 265 Columbia, SC 29210