Wedding Insurance Application

This Application is for the purchase of a one day event/wedding policy. All policies are issued through Brotherhood Insurance. Please submit info and payment to
Bit of Hope Ranch

5001 CR Wood Rd Gastonia, NC 28056

www.bitofhoperanch.org

Bride’s Name	Groom Name
Bride’s Address	Groom’s Address
City/State/Zip	City/State/Zip
What state do you reside?	Date of Wedding Click here to enter a date.
How many guests will be attending?	Other info
Will alcohol be available?
If so, will it be: Sold and if so by who (Caterer, Vendor, Venue) Furnished without a charge Both Sold and Furnished	Alcohol Details
Limit of Liability Needed: $500,000 (cost $165.00 with alcohol or $90.00 with no alcohol) $1,000,000 (will get a quote) $2,000,000 (will get a quote)
Do you want/need Cancellation/Postponement Coverage*, if so, what limit: no $7,500 $15,000 $25,000 $35,000 $50,000 *Coverage does not apply to Change of Heart
Venue Information (Name & Address): *Multiple Venues can be added, info. needed for each	Bit of Hope Ranch 5001 CR Wood Rd Gastonia, NC 28056