Please fill out the insurance payment form below. You will be prompted to provide your credit/debit card details. This is only for us to securely store your financial information for future insurance purchases. Please rest assured that your card will not be charged up-front. Only when you have accepted a client offer and decide to purchase the insurance, will any charge be processed.

 

Remember, payment is not required until you receive your first client offer from us. Upon completion of the form and once payment is made, we will promptly send you an official background check request via our partner, Checkr, and simultaneously forward your details to our insurance company. Kindly note, refunds are not available for this payment once submitted.

 

Thank you for your understanding and cooperation.

 

Again, you do not have to make payment until you receive & ACCEPT your first client offer from us!

 

Please note that your insurance policy will end on 3/30/2025

Insurance Payment Submission Form

Name(Required)
Address(Required)
Please select what payment option you choose(Required)
*Please note that the total insurance payment is $57.00. If you choose the payment plan of the 4 weekly installments, you will be sent a payment page link to set up your payment plan for your insurance policy. If you choose the deduction payment plan, you will be sent an invoice of $25 which must be paid up front before becoming insured with us.

Credit Card

Do you understand that by inputting your payment info above, you agree for us to charge your card?
Once you submit this form, we have the right to charge your card for the selected payment option you choose.
Do you understand that payment is not required until you receive & accept your first client offer?
You do not need to pay for the insurance policy until you receive your first client offer from us and accept it!
Do you agree and understand that once payment is made and your insurance policy is processed, we cannot refund your payment under any circumstances.(Required)
*Please note that once payment is submitted and we process your insurance plan under our general liability policy, we cannot offer any refunds. Reason being is because our insurance company does not allow any refunds once the policy is processed.
Do you agree and understand that if you choose to opt in for our payment plan, that any outstanding balance must be paid regardless of your employment status with InstaSwim.(Required)
Do you agree and understand that if you choose to opt in for our payment plan, if for any reason your contract is ended and you are no longer working with InstaSwim, your outstanding balance must be paid regardless of your employment status with InstaSwim. You agree and understand that InstaSwim has the right to charge your card on file to make this payment.
Do you agree and understand that this insurance coverage covers you ONLY for clients that InstaSwim sends to you from March 30th, 2024, to March 30th, 2025 ONLY?(Required)
Meaning, this liability insurance policy will only cover you for InstaSwim clients, not clients that you sourced on your own. This coverage is only good for clients that are sent your way from March 30th, 2024, to March 30th, 2025.