Associated Irish Therapists Membership Application Form Associated Irish Therapists is an Appointed Representative of Balens Limited who are authorised and regulated by the Financial Services Authority. Zurich Insurance plc is regulated by the Financial Regulator.

WHAT ARE YOU WAITING FOR?

Who are AIT? What do you get when you combine one of the largest insurance companies in Ireland, Zurich Insurance plc (Zurich), the largest specialist broker for health and beauty professionals (Balens), the premier publisher (Irish Beauty) and a team of professionals well respected in the industry, bringing over thirty years experience? The answer, Ireland’s premier membership and insurance company; Associated Irish Therapists (AIT). AIT is designed by therapists, for therapists and as you will see from our application form all therapies are covered by our insurance at a fraction of the cost with much wider cover than you may be used to. If you are fed up of unnecessary paperwork, demands being placed on you from insurance companies who do not understand your business, plus hidden costs, then look no further than AIT. We will assist and help you in every possible way and provide you with the very best level of insurance cover available which includes:-

FULL MEMBERSHIP €469

Includes full insurance to the levels detailed below for all of the standard beauty treatments, holistic and complementary therapies (extensions to the policy are listed on the back page). You also receive all of the other membership benefits and cover is extended at no extra charge for occasional teaching! If you are unsure, give us a call on our freephone number and we will be more than happy to help.

COMPLEMENTARY THERAPISTS €199 Includes full insurance to the levels detailed below for all of the holistic and complementary therapies only. You also receive all of the other membership benefits and cover is extended at no extra charge for occasional teaching! If you are unsure, give us a call on our freephone number and we will be more than happy to help.

NAILS, TANNING AND MAKEUP €199

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€4 million Public Liability should any accidents occur.

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€4 million Treatment Risk Insurance should anything happen while you are performing a treatment.

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€4 million Product Liability should there be any reactions to the products you are using or retailing (this is restricted to €25,000 turnover on products sold to members of the public)

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€4 million Professional indemnity Insurance. Covering you for advice given that could have financial implications.

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€150,000 Legal expenses cover should you have a problem and need any legal advice or representation, including criminal defence, tax cover and help lines. Full details on this fantastic cover on opposite page!

Includes full insurance to the levels detailed below for manicure, pedicure, nail extensions, nail art, semi permanent eyelashes, day makeup, evening makeup, media makeup, fashion makeup and the application of tanning products only. You also receive all of the other membership benefits and cover is extended at no extra charge for occasional teaching! If you are unsure, give us a call on our freephone number and we will be more than happy to help.

SALON €Call

Have you got a salon? More than three staff? Special requirements? We can help, improve your level of cover and save you money on our standard rates. Give AIT a call to day and start saving!

Does your current policy have this level of cover? At AIT we believe in supporting therapists, not putting obstacles in your way making unrealistic demands that will have a negative effect on your business.

Your AIT membership benefits…

What else do I get?...

FREE WORTH €42

FREE STARTER PACK

SUBSCRIPTION

Irish Beauty is the industry leading magazine issued 10 times per year!

FREE LISTING ON THE AIT WEBSITE WORTH €150 PER YEAR!

Enamel badges, window stickers, certificates to display and lots more!

FREE NATIONAL/INTERNATIONAL REPRESENTATION AIT is a global brand, operating in numerous locations around Europe!

FREE AND DEDICATED CONTACT TELEPHONE NUMBERS We value your opinion so pay nothing to give it to us!

FREE TRADE SHOW ENTRY

Promote your business to thousands of potential clients on aitireland.com

Get tickets and free attendance to the Irish Beauty Show

FREE AND SUBSIDISED REGIONAL CPD COURSES WORTH €100 PER YEAR

24 hours a day, 7 days a week!

We will keep you informed of training courses in your area and offer you fantastic discounts

FREE WORLDWIDE COVER This policy is mobile and will cover you to practice around the world. Main domicile must be ROI, temporary trips and excludes USA & Canada.

FREE REPRESENTATION IN THE CASE OF ENQUIRY BY REVENUE COMMISSIONERS WORTH €120 This great benefit even includes accountant’s fees!

FREE LEGAL HELPLINE and... our comprehensive insurance package is also included in the AIT package.

€4 MILLION PROFESSIONAL INDEMNITY INSURANCE Covering you for advice given that could have financial implications.

€4 MILLION PUBLIC LIABILITY INSURANCE Accidents, trips and falls - this is the most common cause of claim in this industry and could cost you millions of Euros - remember, accidents do happen.

€4 MILLION PRODUCT LIABLITY INSURANCE Should there be any reactions to the products you are using or retailing (this is restricted to €25,000 turnover on products sold to members of the public)

€4 MILLION MEDICAL MALPRACTICE/TREATMENT RISK INSURANCE

What if a treatment went wrong? What would you do? Where would you turn?

€150,000 COMPREHENSIVE LEGAL PROTECTION PACKAGE Defence for criminal allegations and many other benefits. Our average claim is €9,000, even when the therapist has done nothing wrong - can you afford not to have this cover? See opposite page for full information on the widest cover on the market today!

AIT Membership provides you with complete peace of mind… ...we won’t let you down.

The Widest Cover on the Market for Health Professionals The new policy is on an innovative upgradable Claims Occurring basis. Balens have managed to include all the benefits of a Claims Made policy and combined it with a Claims Occurring policy thus removing the disadvantages that both usually have!

What does the policy cover? U U

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All premiums include full retroactive cover for previous work performed. The Cover is €4,000,000 per section, any one claim, with unlimited number of claims in the year, plus unlimited defence costs are covered in addition. There is no excess Wide definition of cover is clear and is not restricted to treatment only. Cover includes Medical Malpractice, Professional Indemnity, Public / Products Liability (claims in this section do not reduce the amount covered for other sections of the policy as is normally the case in other policies) and Products Liability (provided for unlimited sales to clients and for up to €35,000 sale to non-clients). Teaching and Student Work cover (running a school can be covered separately). Includes Libel and Slander cover.

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Loss of Reputation expenses to help repair damage to your business in event of a claim against you Breach of Intellectual Property, Client Confidentiality Protection cover, Temporary Trips abroad are covered without a time limit (ex USA and Canada). Ex-UK Domiciles may be covered upon request Loss of Documents cover included €70,000 First Aid cover as well as Good Samaritan Acts. Run off on cessation of cover or practice is included whether your scheme stays with this insurer or not at no charge whatsoever! There are no restrictions or conditions. This is a major improvement on what is usually available through other insurers. Flexible underwriting to accommodate changes in your practice No additional charges for routine changes to cover or duplicate certificates

Also Included is a Legal and Taxation Package through DAS and covers Criminal Defence and other costs up to €150,000! Regretfully, the climate of litigation is still deteriorating, claims incidents criminal allegations including allegations of sexual impropriety or assault are, in our experience, on the increase. We have responded to this situation for individuals, and include our Legal Expenses Package. U U

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Jury or Witness Service Compensation – for lost income as a result of having to attend. Defence of your legal rights involving Criminal Proceedings as well as Data Protection and other legislation cover, wrongful arrest, actions against you for unlawful discrimination etc. Negotiation and representation (including accountants fees) in

The cover is generous and the exclusions few. Wide range of free 24 hour Advicelines, including Legal and Tax Advice, Counselling and other business support services are included. Corporates should take out a wider separate cover.

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event partial or full enquiry by Revenue Commissioners. Some accountants have been known to charge over €120 for this! Business Assistance Helpline for emergencies involving your premises. Disciplinary Hearings Defence and Legal Expenses if you lose your Statutory Licence to practise.

We have always regarded advice, quality cover and personal service as our main strengths, which in themselves can save time and money in the long term. Our collective buying power ensures that you get the best value for money and a unique cover opportunity in this very specialised and limited marketplace.

There are many more features too numerous to mention here!!!

Our Insurance providers Aranged by

Insured through

® WHO ARE BALENS?

WHO ARE ZURICH?

Established in 1950, Balens are an old established 4th generation independant family business, specializing in Health and Beauty Professionals and Businesses. Pioneers and innovators for over 18 years, they are the largest Brokers in this speciality with 33 staff and customized in house software systems. Balens are authorised and regulated by the Financial Services Authority for General Insurance Business extended to allow us to transact business in Eire under the passporting provisions.

Zurich is one of Ireland's leading insurance companies. We offer a wide range of products, from Private Motor and Home Insurance to Engineering and Commercial Property Insurance. We are part of the Zurich Financial Services Group, an insurance-based financial services provider. Our headquarters are in Zurich, Switzerland. Founded in 1872, we now have a global network of subsidiaries and offices in North America, Europe, Asia Pacific, Latin America and other markets. Our 60,000 employees serve customers in more than 170 countrie

FULL MEMBERS TREATMENTS COVERED Acupressure

Bust Treatments

Manual Treatments for Stretch Marks

Alexander Technique

CACI Futuretec Cleansing

Mechanical Massage

Alkaline Skin Wash

Cleansing

Mendhi/Henna/Body Art

Aromatherapy and Blending Essential Oils for Retail

Colour Therapy

Metamorphic Technique

Cranial-Sacral Therapy

Microcurrent (body)

Alpha Hydroxy Acids Glycolic Acids less than 10’ Unbuffered or less than 30% Buffered Esterified Aromatherapy and Blending Essential Oils for Retail Ayurvedic Facials and Body Massage

Crystal Therapy

Microcurrent (face)

Depilatory Creams

Microdermabrasion

Ear Piercing - Lobe Only

Micro Epidermal Skin Abrasion

Electrical Epilation- Diathermy.

Nail Art

Ayurvedic Facials and Body Massage

Galvanic and Blend

Nail Extensions

Baby Massage Instruction

Electrical Epilation Probe Tweezer/Probe

Nora Bode Oxyjet

Barbering. Shaving and Face Massage

Electrical Slimming Toning Treatments

Bleaching

Electrical Treatment for Skin Improvement

Nutrition and Diet Advice given in connection with a Treatment

Baby Massage Instruction

Enlighten

Oxygen Facials – excluding direct inhalation

Blend Epilation

Epil Pro

Paraffin Wax Treatments

Body Electrotherapy

Exercise

Pedicure

Body Massage

Exfoliation Techniques Facial

Crystal Clear: Earth Oxygen

Body Warming

Post-graduate Massage

Body Wraps

Eye Treatments – shaping, tinting, perming, false eye lashes

Bowen Technique

Eyelash Perming

Reiki

Face and Body Painting

Remedial Camouflage

Face Masks

Sauna

Facial Electrotherapy

Self-Tanning Treatments

Facial Massage

Shiatsu

Facial Scrub

Skin Peeling – basic Alpha / Beta hydroxy

False Eyelashes, excluding semi-permanent lashes

Sound Wave Slimming and Toning Sports Massage

Flower Remedies

Spray on Tanning (not mobile booths)

Foot Printing

Stone Therapy

Free Sound Wave

Steaming

Fruit Acids

Steam Cabinets Room

Galvanic Facial

Stress Massage and Management

Galvanic Cellulite Treatment

Sugaring - Strip and Paste

Group Exercise

Sunbed – maximum 1 (in excess of one: additional premium to pay based on number of units)

Hopi Ear Candles - Bio Sun only

Swedish Body Massage

Indian Head Massage

Student Case Studies under supervision and as described in the policy – Students to be named and a certificate will be issued

Individual Exercise

Tai Chi

Infra Red

Thai Massage (Acupressure)

Kinesiology

Threading

Light Therapy

Tuina

Lymphatic Drainage - Face and Body

Toning Tables

Make-up

Tooth Decoration

Manicure

Tweezer Epilation

Manual Exfoliation

Ultrasound on Face and Body

Manual Lymphatic Drainage

Watsu

Manual Treatments for Cellulite

Waxing - Hot and Warm

Hydrotherapy

...Excellent Cover Competitive Price, & Outstanding Benifits!

Spa Treatments

Faradic Muscle Toning

Hair shampooing cutting styling drying colouring permanent waving and hair extensions only

3 great reasons to choose AIT...

Reflexology

Manual Treatments for Skin Improvement

COMPLEMENTARY THERAPISTS TREATMENTS COVERED Acupressure

EmoTrance (if qualified in Reiki or Healing)

Nutrition Therapy

Alexander Technique

Em Power Therapy

On Site Massage

Allergy Testing

Energy Balancing

Phytobiophysics

Angel Therapy (Angels of Ascension, Diana Cooper)

Energy Field Therapy Energy Interference Patterning

Pilates (Mat Work) (Fitness Instructors Clause)

Anger Management

Enneagram

Polarity Therapy

Aromatherapy

Exercise

Post-graduate Massage

Aromatherapy and Blending Essential Oils for Retail

Facial Massage

Provocative Therapy

Feldenkrais Method

Psychotherapy

Foot Printing

Radionics (excluding crops, bldg, soil etc.)

Group Exercise

Reflexology

Herbalism

Reichian Therapy

Holistic Retuning

Reiki

Holographic Re-patterning

Relaxation Therapy

Homoeopathy

Remedial Therapy

Hopi Ear Candles

Rolfing

Hot/Thermal Stone Massage

Shamanism (Not on its own)

Human Givens

Shen Therapy

Hydrotherm Massage

Shiatsu

Hypnotherapy

Sound Healing

Indian Head Massage

Spiritual Psychotherapy

Individual Exercise

Sports Massage

Kairos

Stress Management

Kinesiology

Tai Chi (Non Combat)

Kinetic Energy

Touch for Health

Kirlian / Bio Electrographic

Traditional Chinese Medicine

Light Therapy

Vitamin & Mineral Therapy

Light Touch Therapy

Vortex healing

Life Coaching (Excluding corporate)

Yoga

Manual Lymph Drainage Category 1 & 2

Zero Balancing

Aura-Soma Autogenic Therapy Assemblage Point Shifting Ayurvedic Facials and Body Massage Baby Massage Instruction Bach Remedies Bates Vision Bi Aura Bio Energy Therapy Bio Kinetics Bio Magnetic Therapy Bionetics Body Massage Bowen Technique Buteyko Breathing Therapy / Breathing Massage Celloid Mineral Therapy Chi Kung Cognitive Therapy Colour Therapy Cranio Sacral Therapy Creative Writing

Massage (including deep tissue)

Crystal Therapy

Mechanical Massage

Dowsing for Stress Release Educational Kinesiology

Meditation & Psychic Awareness (no more than 20% of income)

Electro Acupressure

Metamorphic Technique

Electro Crystal Therapy / Electro Gem Therapy

Naturopathy Neuro Linguistic Programming (Not on its own)

Emotional Freedom Technique

Nails, Tanning & Make-up Manicure

Media Makeup

Pedicure

Fashion Makeup

Nail Extensions

Application of Tanning Products

Nail Art Semi Permanent Eyelashes Day Makeup

Plus lots more... ...If yours is not listed, give us a call!

Evening Makeup

WHAT ARE YOU WAITING FOR?

AIT Membership Application Please complete using BLOCK CAPITALS Please complete using BLOCK CAPITALS

SURNAME & TITLE (Dr/Mrs/ Miss/Mr)

FAX

FIRST NAME

EMAIL

DATE OF BIRTH

WEBSITE

HOME ADDRESS

BUSINESS NAME BUSINESS ADDRESS

COUNTY

HOME TEL

COUNTY

WORK TEL

MOBILE

ADDRESS FOR CORRESPONDENCE (delete as appropriate)

HOME HOME//BUSINESS BUSINESS

HOW DID YOU FIND OUT ABOUT AIT? (Please circle, thank you :-) COLLEGE | TRADE SHOW | ADVERT | DIRECT MAIL | RECOMMENDATION

YOUR Training Qualifications NAME & ADDRESS OF COLLEGE / SCHOOL

DATES OF TRAINING

Certificate Enclosed ?

QUALIFICATIONS ACHIEVED (eg. NVQ, SVQ etc. Please enclose qualiication photocopies)

Call Free 1800 625 180 or visit www.ait ireland.com Associated Irish Therapists Limited. 67b High Street, Bidford on Avon, Warwickshire, United Kingdom B50 4AD Tel: 0044 1789 773434 Fax: 0044 1789 773575 E-mail: [email protected]

AIT Membership You have a legal right to cancel the policy within the first 14 days of inception if the cover is unsuitable. In this case a refund of premium may be available subject to an overall minimum retained premium of €80. If you cancel after 14 days no premium refund will be made. Please see the policy wording for full details. AIT reserves the right to refuse membership without reason or prejudice.

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FULL MEMBERSHIP MEMBERSHIP WITH INSURANCE

€ 469

COMPLEMENTARY MEMBERSHIP MEMBERSHIP WITH INSURANCE

€ 199

Sub-Total

NAIL TECHNICIAN, TANNING AND MAKE-UP MEMBERSHIP MEMBERSHIP WITH INSURANCE

€ 199

STUDENT MEMBERSHIP MEMBERSHIP WITH INSURANCE (case study and supervised work only)

€ 25

ASSOCIATE MEMBERSHIP MEMBERSHIP WITHOUT INSURANCE

€ 89

SALON MEMBERSHIP MEMBERSHIP WITH INSURANCE

€ Please Call

Optional Extensions* Laser Hair Removal / Skin Rejuvination Skin rejuvination means delivering an exclusively thermal interaction to improve the appearance of photoaged skin

IPL / High Intense light / Skin Rejuvination Skin rejuvination means delivering an exclusively thermal interaction to improve the appearance of photo-aged skin

Advanced Skin Peeling - to 40% Advanced Alpha / Beta Hydroxy for use in skin peeling provided that the connection does not exceed 16% unbuffered / esterfied or 40% beffered / esterfied

Piercing of the Cartilaginous Portion of the Ear, Nose and Bellybutton Advanced Electrolysis More than two years experience in basic electrolysis required as a minimum

Basic Micropigmentation Basic (lip line, eyebrows and eyeline) fl

Advanced Micropigmentation Including basic and also reconstruction of the nipple, camou age scar tissue and full lip area (inc. Body art)

Teeth Whitening* *Call for information and product acceptability

Sunbeds

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€75.00 €75.00 €75.00 €75.00 €75.00 €133.00 €199.00 €100.00 €75.00

(if more than 1 which is included in the policy for free)

TOTAL *Optional extensions are only available with Ful Membership and Insurance categories

Sub-Total

Information You must give full and true answers to all questions. If you do not do so, your insurance may not cover you in the event of a claim. If you answer yes to any of the questions below, please provide full details of all circumstances on an additional piece of paper. All additional information must be signed and dated by each person to whom the information relates. Please circle the answers to the questions below 1.

Has any insurer ever cancelled, declined or refused to renew any insurance, or accepted the risk at special terms?

YES / NO

2.

Have you had any claims, or incidents which may give rise to a claim under this business or any other business?

YES / NO

3.

Have you ever been convicted of or charged (but not yet tried) with a criminal offence other than motoring?

YES / NO

4.

Have you or any one engaged in the business ever been declared bankrupt or insolvent or become the subject of any bankruptcy or insolvency proceedings?

YES / NO

5.

Do you retail products under your own label? If yes, what is your annual turnover in respect of products

YES / NO

Annual Turnover £………………..

Please send back completed form in envelope enclosed or alternatively, please call the AIT Team on 1800 625 180 or email [email protected] In the case of salon membership please ensure all staff have completed an application form and signed the declaration. Please make cheques/postal orders payable to AIT LTD. and send to: Associated Irish Therapists Ltd. 67b High Street, Bidford-on-Avon, Warwickshire, United Kingdom B50 4AD Fax: 0044 1789 773575 If you wish to pay by credit or debit card please fill in your details below

NAME AS ON CARD TYPE OF CARD

/

CARD NUMBER START DATE SECURITY CODE*

/

/ EXPIRY DATE

/ /

ISSUE NO. (SWITCH)

SIGNATURE DATE

*The security code is the last 3 figures printed on the signature strip located on the reverse of your card.

Declaration

Data Protection Zurich Insurance plc (“Zurich”) will hold your details in accordance with our Data Protection and Privacy Policy together with all applicable data protection laws and principles. Information you supply may be used by us for the purposes of administering your policy (including underwriting, processing, claims handling and fraud prevention) within the Zurich Financial Services Group and our partners inside and outside the European Economic Area. We may share with our agents and service providers, members of the Zurich Financial Services Group, other insurers and their agents, and with any intermediary acting for you, and with recognised trade, governing and regulatory bodies (of which we are a member or by which we are governed) information we hold about you and your claims history. This includes the Insurance-Link database and the Irish Insurance Federation’s anti-fraud claims matching database. We may also in certain circumstances use private investigators to investigate a claim. We may also need to collect sensitive personal data (for example, information relating to your physical or mental health or the commission or alleged commission of an offence) to assess the terms of insurance we issue/arrange or to administer claims which arise.

Unless you have advised us otherwise, we may share information that you provide to companies with the Zurich Financial Services Group and with other companies that we establish commercial links with so we and they may contact you (by email, SMS, telephone or other appropriated means) in order to tell you about carefully selected products, services or offers that we believe will be of interest to you.

1. I/We declare to the best of my/our knowledge and belief that the information given on this form is true in every respect. 2. I/We declare that if anything on this form was written by another person he or she acted as my/our agent for this purpose. 3. I/We agree that this proposal and declaration shall be the basis of the contract between me/us and the insurer

Please tick here if you do not wish your information to be utilised for these purposes

IMPORTANT NOTICE: Failure to disclose material facts could result in your contract being invalidated. Material facts are those facts which might influence the acceptance or assessment of your proposal. If you are in doubt as to whether a fact is material you should disclose it. A copy of this proposal form is available on written request within three months from the date of this proposal. Full details of the cover provided appears in the policy document, a copy of which is available on request. Telephone calls may be recorded for security and training purposes.

You have a right of access to and a right to rectify data concerning you under the Data Protection Acts 1988 and 2003. Should you wish to exercise this right, please write to the Data Protection Officer, Zurich, Zurich House, Ballsbridge Park, FREEPOST, Dublin 4. To access your data, a fee of 6.35 is chargeable under the terms of the Data Protection Acts and cheque should be made payable to Zurich By providing us with your information and proceeding with this contract, you consent to all of your information being used, processed, disclosed, transferred and retained for the purposes of insurance administration (including underwriting, processing, claims handling and fraud prevention). Please note that a copy of our full Data Protection and Privacy Policy can be viewed on our website www.zurich.ie or requested by writing to our Data Protection Officer at Zurich, Zurich House, Ballsbridge Park, FREEPOST, Dublin 4.

The insurer reserves the right to decline any proposal.

SIGNATURE DATE

Prices listed above include 3% Irish Levy tax and 5% AIT documentation fee.