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March 14,2021 COMMUNICABLE DISEASE EXPOSURE AND INFECTION ASSUMPTION OF RISK, HOLD HARMLESS, RELEASE, WAIVER OF LIABILITY AND INDEMNITY AGREEMENT ________________________________ FILL IN TRACK

SAFEHOLD SPECIAL RISK, INC. COMPLETE ALL SECTIONS PROMOTER TRACK SANCTIONING BODY / PROMOTER NHRA  TRACK PROMOTED  WDRA  IMCA  IHRA 

FatherMotherGuardian: Textfield-0: FatherMotherGuardian-0: Printed Name of MINOR Participant: DOB: Address of Participant: Printed Name of Parent or Guardian 1: Printed Name of

Name of Track andor Event: Event Dates: Textfield-0: Textfield-1: Textfield-2: Textfield-3: Textfield-4: Textfield-5: Textfield-6: Textfield-7: Textfield-8: Textfield-9:

CONTACT US Bob Allen Account Executive and Producer Safehold Motorsports Program O: (704) 901-8639 | C: (507) 327-8416 bob.allen@igpspecialty.com Visit us at igpspecialty.com Speed,

Facility Insurance Application Facility Name I Facility Age Contact Person I Title Facility Location Phone I Fax I Email Annual Admissions I Seating I Total Capacity I Total Gross Receipts

HEALTH CLUB FACILITY SUPPLEMENTAL GENERAL LIABILITY APPLICATION (Separate application required for each location) Effective Date: Date of Application: -------------------- ---------------

Skating Facility Inflatables Supplemental Application Separate application required for each location I. General Information Named Insured I DBA Facility Address Website I Email II.

Supplemental Sports Facility Questionnaire Separate application required for each location I. General Information Named Insured DBA Facility Address Website Email Is the applicant: Is the

CONTACT US Dallas: (800) 232-5830 Kerrisa Woodard Professional Liability Division (423) 983-7131 kerrisa.woodard@usrisk.com igpspecialty.com A Accreditation Organizations Actuaries Adjusters

Wholesale Professional & Executive Liability ©2026 INNOVATION GROWTH PARTNERS SPECIALTY, LLC REV 03.12.26 igpspecialty.com Your Wholesale Solution for Hard-to-Place Insurance Agency E&O IGP

GENERAL COVERAGE FEATURES ■ Available limits $2M/$4M per claim/ annual aggregate ■ Full prior acts available ■ Defense outside available ■ Duty to defend ■ 80/20 hammer/settlement clause ■

PROFESSIONAL LIABILITY ■ Defense outside limit option available ■ Personal injury included when related to professional services ■ Contingent BI/PD coverage available ■ Claims Made and

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No Resort is Quite Like Yours Safehold Sports has over 55 years of insurance experience and in-depth knowledge of the ski and outdoor recreation industry. Our team provides insurance programs to

Where Outdoor Risk Meets Industry Expertise For more than 55 years, Safehold Sports has specialized in protecting businesses across the snowsports and outdoor recreation industries. From ski

COMPLETE ALL SECTIONS PROMOTER TRACK SANCTIONING BODY / PROMOTER NHRA  TRACK PROMOTED  WDRA  IMCA  IHRA  OTHER  _____________________ EVENT TYPE DRAG  OVAL  ROAD

Release and "Waiver of Liability Assumption of Risk and Indemnity Agreement Name of Track and/or Event: _______________________ Event Date(s) : __________ _ IN CONSIDERATION of being permitted to

Batting Cages Supplemental Questionnaire Separate application required for each location I. General InformationNamed Insured I OBA Facility Address Website I Email II. Batting Cage

HEALTH CLUB FACILITY SUPPLEMENTAL GENERAL LIABILITY APPLICATION (Separate application required for each location) Effective Date: Date of Application: -------------------- ---------------